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目的 :探讨急性髓系白血病 (AML)合并弥散性血管内凝血 (DIC)肝素治疗的最有效剂量。方法 :中小剂量肝素(Midlowdoseheparin ,MLDH)肝素用量为 12 5～ 2 5 0U/kg ,2次 /日治疗 (19例 )及微剂量肝素 (亦称超小剂量肝素 ,Ul tralowdoseheparin ,ULDH)肝素用量为 2 5～31.2 5U/kg ,2次 /日治疗 (19例 )AML合并DIC38例 ,给药途径均为腹部脐周或上臂内侧皮下注射。按全国统一标准评定疗效。结果 :MLDH肝素治疗后部分病人有新的出血 ,早期死亡率高 ,化疗过程中DIC的治愈率为 (4/ 18) 2 2 % ,明显低于ULDH治疗组 (12 / 2 0 )的 6 0 % ,且必须进行DIC监测。结论 :ULDH临床无出血倾向 ,不须进行实验室监测 ,早期死亡率明显降低 ,可以作为预防治疗AML并DIC的首选药物剂量。
Objective: To investigate the most effective dose of acute myeloid leukemia (AML) combined with disseminated intravascular coagulation (DIC) heparin. Methods: The dosage of heparin in middle and small dose of heparin (MLDH) was 125 ~ 250U / kg, twice daily (n = 19) and micro heparin (also known as ul tralowdose heparin, ULDH) The patients were treated with DML in the range of 25 ~ 31.2 5U / kg and 2 times / day (19 cases). AML and DIC were given in 38 cases. The routes of administration were all subcutaneous injection into the abdominal umbilical or medial upper arm. According to a unified national standard assessment of efficacy. Results: Some patients had new hemorrhage and early mortality after MLDH heparin treatment. The cure rate of DIC during chemotherapy was (4/18) 22%, which was significantly lower than that of ULDH treatment group (12/20) %, And must be DIC monitoring. Conclusion: ULDH has no clinical tendency of bleeding and no need of laboratory monitoring. The early mortality rate of ULDH is obviously reduced, which can be used as the first choice of drug for prevention and treatment of AML and DIC.