PICC对恶性肿瘤患者血浆D-二聚体水平的影响

The influence of PICC on plasma D-dimer level in cancer patients

目的:观察恶性肿瘤患者PICC前后D-二聚体水平变化及影响因素分析。方法:分析140例PICC置管的恶性肿瘤患者,采用乳胶增强免疫比浊度法检测置管前1周内及置管后4周内D-二聚水平。PICC前后D-二聚体水平比较采用两相关样本Wilcoxon秩和检验,各组间比较采用两独立样本Wilcoxon秩和检验或多组独立样本Kruskal-Wallis H检验。结果:PICC前D-二聚体水平在各组间无显著性差异(P>0.05)。PICC置管后D-二聚体水平0.995(0.568,1.568)mg/L较置管前0.680(0.375,1.255)mg/L上升(P<0.001)。肿瘤分期为Ⅳ期者PICC前后D-二聚体水平差值0.3 4 0(0.040,0.653)mg/L较Ⅱ/Ⅲ期者0.060(-0.215,0.333)mg/L高(P=0.001)、年龄>60岁者为0.415(0.055,0.773)mg/L较≤60岁者0.160(-0.080,0.390)mg/L高(P=0.0001),余组间无显著性差异(P>0.05)。结论:PICC使肿瘤患者D-二聚体水平上升,其危险因素包括肿瘤分期为Ⅳ期及年龄>60岁。

Objective： To explore the plasma D - dimer levels before and after peripheral ly inserted central venouscatheters（PICC） in cancer patients and analyze the influence factors. Methods：Total of 140 cases of cancer patients who received PICC were included. The plasma D - dimer levels before PICC within one week and after PICC within 4 weeks were detected by Latex - enhanced immunoturbidimetric assay. The comparison of the plasma D - dimer levels before and after PICC was used two related samples Wilcoxon rank sum test. The plasma D - dimer level differences between groups were analyzed by two independent samples Wilcoxon rank sum test or multiple sets of independent samples Kruskal - Wallis H test. Results： Before PICC, the differences of plasma D - dime r levels between gropus were not statistically significant（ P 〉 0. 05 ） . The plasma D - dimer level after PICC was 0. 995 （0. 568,1.568 ） mg/L, which was higher than the level before PICC 0. 680（0. 375,1.255） mg/L（ P 〈0. 001 ） . The plasma D - dimer level of concentration differences before and after PICC in clinical stage IV was 0. 340（0. 040,0. 653）mg/L,which was high-er than the level in clinical stage n/IH 0. 060（ - 0. 215 ,0. 333） mg/L（ P = 0. 001 ）. The plasma D - dimer level of concentration difference before and after PICC in age 〉60 years was 0. 415（0. 055,0. 773 ） mg/L, which was higherthan the level in age ^60 years 0. 160（ - 0. 080,0. 390） mg/L（P =0.001）. Other groups were not statistically dif-ferent（ P 〉 0. 05 ） . Conclusion ： PICC could elevate plasma D - dimer level , and the r is k factors included tumor stage IV and over 60 years old.