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目的:探讨APL合并DIC的治疗和恢复情况及其临床特征和高危因素。方法:4 a来APL合并DIC患者156例,分初治组和复发组,用亚砷酸治疗APL,高白期加羟基脲同时治疗DIC,应用SAS软件分析APL合并DIC的危险因素并提出DIC分型标准。结果:APL合并DIC临床表现以皮肤黏膜出血为著。DIC发生率及治愈率在初治组和复发组间差异无显著性,复发组死亡率高于初治组。DIC高危因素与WBC、Plt、LDH值、脏器出血及栓塞有关。结论:亚砷酸无直接诱发DIC作用,患者早期,WBC过高、Plt<10×109/L、LDH升高预示高危。DIC治疗以输注血小板、纤维蛋白原、血浆等加肝素为主。
Objective: To investigate the treatment and recovery of APL combined with DIC and its clinical features and risk factors. Methods: A total of 156 patients with APL complicated with DIC were enrolled in this study. One hundred and seventy patients with primary DIC and advanced DIC were enrolled in this study. APA was treated with arsenite and hyperbaric plus hydroxyurea were given concurrent treatment for DIC. SAS software was used to analyze the risk factors of APL combined with DIC. Classification criteria. Results: APL combined DIC clinical manifestations of mucocutaneous bleeding. DIC incidence and cure rate in the initial treatment group and recurrence group no significant difference, the recurrence group mortality was higher than the initial treatment group. DIC risk factors and WBC, Plt, LDH values, organ bleeding and embolism. Conclusion: Arsenic trioxide has no direct effect on DIC. In early stage of patients, WBC is too high, Plt <10 × 109 / L, elevated LDH indicates the high risk. DIC treatment to infusion of platelets, fibrinogen, plasma plus heparin-based.