血浆D-二聚体水平与恶性肿瘤患者发生静脉血栓的相关性

The correlation between the level of plasma D-dimer and venous thromboembolism on cancer patients

目的:观察血浆D-二聚体(D-dimer,D-D)水平对恶性肿瘤患者相关静脉血栓栓塞症(venous thromboembolism,VTE)发生的风险评估效果。方法:回顾性分析2016年1月至2017年1月本院新收住并经病理组织学证实的171例恶性肿瘤患者的临床资料,以初诊3个月内是否发生静脉血栓栓塞症(VTE)分为VTE组(32例)和非VTE组(139例),比较两组患者、不同临床分期患者、不同治疗方式患者、不同静脉血栓风险分层患者的血浆D-D值水平,采用Logistic多因素回归分析血浆D-D水平对恶性肿瘤患者相关VTE发生的风险评估效果。结果:VTE组的血浆D-D值水平显著高于非VTE组(P<0.05),且随着恶性肿瘤临床分期的增加和静脉血栓风险分层的增高,该现象更加显著。Logistic多因素回归分析结果表明,化疗、手术、静脉血栓风险评估和血浆D-D水平是患者发生VTE的独立危险因素(P<0.05)。结论:恶性肿瘤患者血浆D-D值水平明显升高,且与恶性肿瘤的临床分期和血栓风险分层相关;对恶性肿瘤患者进行血浆D-D值水平的检测,对预防恶性肿瘤患者初诊3个月内VTE的发生具有十分重要的参考意义。

Objective： To investigate the value of the level of plasma D-dimer（ D-D） in estimation of venous thromboembolism（ VTE） risk on cancer patients. Methods： The clinical data of 171 cases of cancer patients registered in the Hospital from January 2016 to January 2017 were retrospectively analyzed,and divided into VTE group（ n= 32） and non-VTE group（ n = 139） according to the results of the first 3 months. The level of plasma D-D was compared between the VTE and non-VTE groups,among the patients with different clinical stages or venous thrombosis risk stratification. Multivariate Logistic regression analysis were performed to investigate the value of the level of plasma D-D in estimation of VTE risk on cancer patients. Results： VTE group of plasma D-D was significantly higher than the non-VTE group（ P＜0. 05）,and with the increase of the clinical stage and venous thrombosis risk levels,the phenomenon was more serious. Results of multivariate Logistic regression analysis showed that chemotherapy,surgery,venous thrombosis risk levels and plasma D-D level were the independent risk factors for VTE in the cancer patients（ P＜0. 05）. Conclusion： The plasma D-D level is significantly increased in cancer patients,and is associated with the clinical stages and venous thrombosis risk levels. The detection of plasma D-D level in patients with malignant tumor is very important for the prevention of malignant tumor in 3 months.