Clinical Analysis Of 100 Cases Of Acute Promyelocytic Leukemia Complicated With Coagulopathy

Objective Understand the risk factors of APL with coagulopathy abnormalities,related laboratory tests,clinical manifestations of coagulation abnormalities,and the response after treatment,and analyze the causes of early death,timely prevent coagulation dysfunction and abolish the development of DIC for clinical improvement The survival rate and quality of life of APL patients and the reduction of mortality provide a useful reference.Methods The clinical data of 100 patients with APL combined with abnormal coagulation function in Hematology Department of our hospital from January 2010 to April-2017 were collected and analyzed retrospectively.The patients were divided into two groups of patients with diffuse intravascular coagulation(DIC)and non diffuse intravascular coagulation(NDIC)according to the difference in the abnormal degree of coagulation function.The general situation,the related coagulation indexes,the clinical characteristics and the therapeutic effect were evaluated and the outcomes were summarized.The data were finally analyzed by SPSS 22 software.The measurement data were expressed as(X + S),normal distribution t test,non normal distribution Maan-Whitney U test,counting data,X inspection,P < 0.05 showed statistical significance.Results 1.100 APL patients,the incidence of non DIC group was 44%,DIC group was 56%.There was no difference in age and sex between the two groups.There was a correlation between leukocyte count and platelet count and abnormal coagulation function at admission(P < 0.05).2.the clinical manifestations were different bleeding.The bleeding rate of APL combined with DIC was 87.5%,which was significantly higher than that in the non DIC group,and the main manifestations were skin and mucous bleeding.3.22 cases(22%),80 cases(80%)of PLT<40×109/L,8 cases of The increased leukocyte count,30 cases of thrombocytopenia in non DIC group,14 cases of The increased leukocyte count,50 patients with thrombocytopenia,and two patients with thrombocytopenia,and the related coagulation index in the non DIC group.The standard exceptions are mainly expressed in FIB,D-D2,FDP,and PTL.4.the remission rate of the two groups after remission treatment was not different: the non DIC group 81.8%,the DIC group 57.1%,the remission time: the non DIC group 28.7d,the DIC group 32.5d,two groups compared,the DIC group decreased the remission rate compared with the non DIC group,and the remission time was obviously prolonged.At the same time,the two groups of patients give blood products after symptomatic supportive treatment,the prognosis of abnormal coagulation function is relatively good.Conclusion 1.APL combined with coagulation dysfunction is common in the early stage.The increased leukocyte count is a risk factor and should be prevented at an early stage.2.The positive rates of FIB,D-D2,FDP and PTL were higher in related laboratory tests,especially D-two polymer,95% in non DIC group and 100% in DIC group,so it could be used as a valuable indicator for diagnosis of coagulation abnormalities.3.The bleeding rate of two groups of patients in this study was not DIC70.5%,DIC group was 87.5%,manifested as multiple site bleeding,mainly skin and mucous membrane.Deep organ bleeding,especially cerebral hemorrhage,is the main cause of death.4.APL combined with DIC were lower and longer than those of non DIC patients.5.Two groups of patients after treatment and treatment,coagulation abnormalities in relatively good outcome.