血栓弹力图联合D-二聚体的检测对预测肿瘤患者静脉血栓发生的探讨

目的 探讨血栓弹力图(TEG)联合D-二聚体对预测肿瘤患者发生深静脉血栓的诊断价值。方法：回顾性分析2016年1月到2019年12月本院初诊为恶性肿瘤的患者200例,以三个月是否发生深静脉血栓栓塞症(VTE)分为VTE组和非VTE组,分析两组患者外周血TEG各参数和血浆D-二聚体水平的差异。结果：(1)200例恶性肿瘤患者VTE的发生率为14.50%。(2)恶性肿瘤发生VTE时,TEG检测中的MA值和D-二聚体明显高于非VTE组,差异均具有统计学意义(P<0.05)。(3)ROC曲线显示,恶性肿瘤发生VTE时,MA值、D-二聚体的最佳临界值分别为67.20mm和1.57mg/L,其敏感度分别是93.10%、89.70%,特异度分别为53.92%、71.53%,准确度分别为65.00%、74.00%,AUC分别为0.767,0.878。两者联合检测敏感度为96.55%,特异度为51.46%,准确度为58.00%,AUC为0.891。结论：TEG联合D-二聚体检测,可作为初诊为恶性肿瘤的患者在治疗过程中监测VTE发生的筛查指标,对于恶性肿瘤发生VTE的诊断具有一定的临床意义。

Probe into the prediction of venous thrombosis in tumor patients by TEG combined with D-dimer detection

ABSTRACT: Objective To explore the diagnostic value of TEG combined with D-dimer(D-D) in predicting VTE of tumor. Methods The clinical data of 200 cases of cancer patients registered in the Hospital from January 2016 to December 2019 were retrospectively analyzed, and divided into VTE group and non-VTE group according to the results of the first 3 months. The level of peripheral blood TEG and plasma D-D were compared between the VTE and non-VTE groups. Results (1) The probability of VTE in 200 patients with malignant tumors was 14.5%. (2) When VTE occurred in malignant tumors, the level of MA and D-D were significantly higher than those in non-VTE groups, and the difference was statistically significant(P<0.05). (3)The ROC curve shows that when VTE occurs in malignant tumors, the optimal cut-off values for MA and D-D were 67.20mm and 1.57mg/L ,their sensitivities were 93.10% and 89.70%,their specificity were 53.92% and 71.53%,their accuracy were 65.00% and 74.00%,their AUC were 0.767 and 0.878.The joint detection sensitivity of the two was 96.55%,the specificity was 51.46%,the accuracy was 58.00% and AUC was 0.891.Conclusion The detection of TEG combined with D-D can be used as an initial screening indicator for the occurrence of VTE during the treatment of patients with newly diagnosed malignant tumors.