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

摘要

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 regis-tered 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 throm-bosis 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 chemothera-py,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.