白血病患者の口腔粘膜潰瘍に関する研究

血液凝固第XIII因子, 血漿fibronectin,α₂-plasmin inhibitorの変動を中心に

抄録

Plasma levels of factor Xifi and its substrates [plasma fibronectin (PFN) and α₂-plasmin inhibitor (α₂-PI)] were measured in leukemia patients with intractable oral mucosal ulcers to study the implications of these parameters in ulcer formation and healing. The findings were as follows:
1. Oral mucosal ulcers appeared predominantly on the buccal surface of the gingiva at the lower molars and at the margin of the tongue.
2. Regarding the relationship between oral mucosal ulceration and chemotherapy agents, the incidence of ulcers was higher when Ara-C, ADM, DNR, VCR or PSL were administered.
3. There was no significant difference in the plasma factor XIII level between healthy individuals and leukemia patients without ulcers, while PFN and α₂-PI levels were slightly higher in the latter.
4. Factor XIV PFN and α₂-PI levels were significantly lower at the time of oral mucosal ulcer formation than in the absence of an ulcer.
5. The platelet count was significantly lower in the presence of an oral mucosal ulcer than in its absence.
6. There was no significant difference between the time of oral mucosal ulcer formation and absence of ulcer in terms of plasma fibrinogen (Fib) level, WBC count or neutrophil count.
7. The CRP level was significantly higher at the time of oral mucosal ulcer formation than in the absence of such an ulcer, while the T-P level showed no significant difference between the presence and absence of oral mucosal ulcer.
8. The incidence of ulcer formation was higher in patients with a WBC of <1, 000/mm³ and a neutrophil count of <500/mm³.
9. No correlation was noted between the factor XIII level, the α₂-PI level, the PFN level and the platelet count at the time of oral mucosal ulcer formation.
10. A positive correlation was shown between factor XIII and PFN levels, between the α₂-PI and Fib. levels, between the factor XIII level and platelet count, and between the factor XIII and T-P levels in the absence of an oral mucosal ulcer.
Various blood parameters were thus measured in leukemia patients in the presence and absence of ulcerous lesions of the oral mucosa and the results suggested that factor Xifi and related factors forming its substrate may play a role in the development and healing of ulcers.