20余年来,由于联合化疗方案的改进、新药物的发现以及骨髓移植的开展,急性白血病的缓解率明显提高,大部分病人可达到完全缓解,少数病人可获治愈。但临床上见到一些急性白血病病程险恶,病人常在短期内死亡,白细胞过高性急性白血病即属此类。 1 白细胞过高性急性白血病是指急性白血病周围血白细胞计数>100×10～9/L者,约占急性白血病的5％,其病理生理特点如下。1.1 大量原始细胞淤滞在肺、脑和其他器官、组织的微循环中,可见大量原始细胞淤滞,白血病细胞体积大,变形能力差,且形态常不规则,在低切变速率下常难通过微血管,尤其是单核细胞对血管壁具有更大的粘附性,比原始淋巴细胞对微循环产生更为不利的影响。我院尸检3例急性白血病,白细胞>100×10～9/L,均有白血病细胞在肺、脑微循环中的堆积。白血病细胞在微循环中的阻塞引起器官组织供氧减少,组织缺氧。此外,白血病细胞耗氧增加,使局 For more than 20 years, due to the improvement of combination chemotherapy, the discovery of new drugs and the development of bone marrow transplantation, the remission rate of acute leukemia has been significantly improved. Most patients can achieve complete remission and a small number of patients can be cured. However, the clinical course to see some of the dangers of acute leukemia, the patient often died in the short term, leukemia, acute leukemia that belong to this category. 1 leukemia acute leukemia refers to acute leukemia peripheral white blood cell count> 100 × 10 ~ 9 / L, accounting for about 5% of acute leukemia, the pathophysiological characteristics are as follows. 1.1 A large number of primitive cell stasis in the lung, brain and other organs, tissue microcirculation, showing a large number of primitive cell stasis, leukemia cells bulky, poor deformability, and the shape is often irregular at low shear rate is often difficult through the microvascular , Monocytes in particular have greater adhesion to the blood vessel wall and have a more adverse effect on microcirculation than naive lymphocytes. My courtyard autopsy 3 cases of acute leukemia, white blood cells> 100 × 10 ~ 9 / L, leukemia cells are accumulated in the lung and brain microcirculation. Blockage of leukemic cells in the microcirculation causes reduced oxygen supply to the tissues of the organ and hypoxia in the tissues. In addition, leukemia cells increase oxygen consumption, making the bureau