D-dimer及PF1+2与晚期恶性肿瘤患者静脉血栓栓塞症的相关性的研究

目的]探讨血浆D-dimer及PF1＋2与晚期恶性肿瘤患者静脉血栓栓塞症（VTE）的相关性。方法]150例晚期恶性肿瘤患者随机分为2组,其中117例无VTE的患者为非栓塞组,33例发生VTE的患者为栓塞组。所有患者均在化疗前及第2、第4、第6个疗程化疗后第7d至第10d期间检测血浆中D-dimer和PF1＋2的含量。结果]随着化疗的进行患者血浆D-dimer、PF1＋2呈上升趋势,且栓塞组高于非栓塞组（P〈0.05）;恶性肿瘤患者血浆中Ddimer和PF1＋2呈显著正相关关系（r=0.53,P〈0.05）,而D-dimer、PF1＋2与患者的年龄、性别、病程、病理分型、临床分期均无相关性（P〉0.05）;多因素Logistic回归分析结果显示：血浆Ddimer、PF1＋2是化疗后VTE发生的独立危险因素,而接受抗凝治疗是化疗后VTE发生的保护因素。结论]血浆D-dimer、PF1＋2对晚期恶性肿瘤患者VTE的发生具有一定的诊断价值,接受化疗的晚期恶性肿瘤患者应采取适当的抗凝治疗预防VTE的发生。

The Correlation of D-dimer and PF1+2 in Malignant Patients with Venous Thromboembolism

Purpose] To investigate the correlation of D-dimer and PF1 ＋2 with in malignant patients complicated with venous thromboembolism（VTE）. Methods] One hundred and fifty malignancies were randomly divided into two groups：non-embolization group（117 cases without VTE） and embolization group（33 cases with VTE）. The plasma D-dimer and PF1＋2 were tested in all patients before chemotherapy,and at the seventh day to the tenth day during the second,fourth,sixth course of chemotherapy respectively. Results]The plasma D-dimer,PF1 ＋2 increased with the progress of chemotherapy,and the embolization group had higher leves than the the non-embolization group（P＆lt;0.05）.The D-dimer and PF1＋2 had a significant positive correlation in malignant patients（r =0.53,P ＆lt;0.05）,while the D-dimer,PF1 ＋2 had no correlation with the patient’s age,gender,duration of disease,pathological type,clinical stage（P＆gt;0.05）.Logistic regression analysis showed that plasma D-dimer,PF1＋2 were the independent risk factors for VTE after chemotherapy,and anticoagulation therapy after chemotherapy was the protective factor for VTE. Conclusion] Plasma D-dimer,PF1＋2 have diagnostic value for VTE in malignant patients. The advanced cancer patients undergoing chemotherapy treatment should take anticoagulation therapy to prevent the occurrence of VTE.