血浆D-二聚体在恶性淋巴瘤患者疗效评价中的价值

Clinical significance of plasma D-dimer level in therapeutic evaluation of patients with malignant lymphoma

目的 探讨恶性淋巴瘤患者化疗前后血浆D-二聚体水平变化在疗效评价中的价值.方法 回顾性分析2011年1月至2013年11月天津医科大学肿瘤医院收治的经病理证实的恶性淋巴瘤患者402例,分析患者血浆D-二聚体水平与临床病理特征之间的相关性,评价患者化疗前后血浆D-二聚体水平变化与化疗效果的相关性.结果 恶性淋巴瘤患者的血浆D-二聚体水平中位数为734.51 ng/ml,明显高于正常范围（＜ 500 ng/ml）;高龄、非霍奇金淋巴瘤、乳酸脱氢酶升高、Ⅲ～Ⅳ期、B症状及国际预后指数（IPI）评分＞2分的患者,D-二聚体水平明显升高（均P＜ 0.05）.化疗有效组D-二聚体水平由化疗前的949.40 ng/ml降低至499.88 ng/ml,差异有统计学意义（P＜0.05）;化疗无效组D-二聚体水平由化疗前的611.09 ng/ml升高至899.76 ng/ml,差异有统计学意义（P＜0.05）.结论 恶性淋巴瘤患者血浆D-二聚体水平明显升高,且与临床病理特征相关,化疗前后血浆D-二聚体水平的变化可为疗效评价提供一定依据.

Objective To explore the clinical significance of plasma D-dimer level before and after chemotherapy in patients with malignant lymphoma.Methods 402 patients admitted to Tianjin Medical University Cancer Institute and Hospital and pathologically diagnosed with malignant lymphoma were retrospectively analyzed to investigate the relationship between patients＆#39; plasma D-dimer level and their clinic pathology.Meanwhile,the association between patients＆#39; plasma D-dimer level change after chemotherapy and therapeutic effect was also evaluated.Results The median plasma D-dimer levels in malignant lymphoma patients （734.51ng/ml） was distinctly higher than that in normal population （〈500 ng/ml）.The plasma D-dimer level had obvious correlation with age,pathological type,level of LDH,clinical stage,B symptom and IPI score.The level of plasma D-dimer in positive response group significantly decreased from 949.40 ng/ml to 499.88 ng/ml after chemotherapy （P 〈 0.05）,whereas that in the negtive response group significantly increased from 611.09 ng/ml to 899.76 ng/ml （P 〈 0.05）.Conclusion The level of plasma D-dimer may provide the basis for evaluating the chemotherapeutic effect in patients with malignant lymphoma.