P-选择素、D-二聚体早期诊断门静脉血栓形成的价值

Predictive value of P-selectin and D-dimer in early diagnosis of portal vein thrombosis

目的:探讨检测P-选择素、D-二聚体在早期诊断门静脉高压症术后门静脉血栓形成(PVT)中的价值。方法:对82例经手术治疗的门静脉高压症患者行门静脉彩色多普勒检查,根据有无PVT将患者分为PVT组和非PVT组,动态检测2组患者血清P-选择素、D-二聚体含量,并采用受试者特性(ROC)曲线分析二指标联合检测诊断PVT的价值。结果:PVT组术后P-选择素水平、D-二聚体水平均高于对照组,PVT发生前P-选择素水平、D-二聚体水平亦均高于对照组最高值(P<0.01)。P-选择素、D-二聚体以及二者联合检测PVT的ROC曲线下面积分别为0.933、0.880和0.931,3种检测的敏感性分别为85.2%、88.9%和82 0%,特异性分别为85.5%、78.2%和97.6%。结论:门静脉高压症术后P-选择素、D-二聚体二指标联合动态检测有助于PVT的早期诊断。

Objectivet To nvestigate the predictive value of P-selectin and D-dimer in the early diagnosis of portal vein thrombosis（PVT） in patients submitted to portal hyloertension operation. Method： Eighty-two patients were assigned into two groups （PVT group and non-PVT- group）after the operative treatment of portal hypertension. The levels of P-selectin and D-dimer were detected dynamically in the patients of two groups. Results： The preoperative levels of P-selectin and D-dimer in the PVT group werehigher than those in the non-PVT group respectively （P〈0.01）, and the levels of P-selectin and D-dimer in PVT group just before PVT occurred were higher than the top levels in the control group respectively（P〈0.01）. Receiver operating characteristic （ROC） curve analysis indicated that the areas under the ROC curve of P-selectin, D-dimer and their combinative detection were 0.933, 0.880 and 0.931 respectively. The sensitivities of P-selectin, D-dimer and their combinative detection were 85.2%, 88.9% and 82,0%, The specificities of P-selectin, D-dimer and their combinative detection were 85.5%, 78.2% and 97.6%. Conclusion： Detecting P-selectin and D-dimer level dynamically would be helpful to the early diagnosis of PVT after portal hypertension operation.