P-sel、TpP、D-D联合检测预测门静脉高压症患者术后发生门静脉血栓的价值

目的探讨P-选择素（P-sel）、血栓前体蛋白（Tp P）和D-二聚体（D-D）联合检测预测门静脉高压症患者术后并发门静脉血栓的价值。方法选择2010年8月至2013年9月于我院行门静脉高压症手术的68例患者作为研究对象,患者分别于手术前后进行P-sel、Tp P和D-D的含量检测,根据术后血栓发生与否进行分组,并对检测结果进行比较分析。结果患者术后发生血栓37例（血栓组）,未发生血栓31例（正常组）,术后1 d血栓组患者P-sel、Tp P及D-D浓度均较术前明显升高,术后7 d逐渐降低,而正常组患者术后14 d内均无明显变化,差异具有统计学意义（P〈0.05）。三项指标检测在术后第一天预测门静脉血栓形成方面特异性最高者为P-sel,其次为D-D、Tp P,灵敏度表现为Tp P〉D-D〉P-sel的特点,且P-sel的误诊率最低,仅为8.8%。结论术后并发门静脉血栓患者大多术后第一天即可出现P-sel、Tp P和D-D浓度显著升高,而术后P-sel、Tp P和D-D三项的检测结果对预测门静脉血栓的形成具有辅助作用。

Predictive value of P-sel,TpP, D-D joint detection for postoperative portal vein thrombosis in patients with portal hypertension surgery

Objective To discuss the predictive value of joint detection with P-sel, TpP, D-D for portal vein thrombosis in patients with portal hypertension surgery. Methods We selected 68 patients who had portal hypertension surgery in our hospital （time limited from August 2010 to September 2013） as research subjects, and tested the content of P, sel, TpP and D-D respectively before and after surgery. The subjects we divided into Group Normal and Group Thrombus according to their occurrence of postoperative thrombosis, then the test results were analyzed. Results After the surgery, there were 37 cases of patients with thrombus （Group Thrombus） and other 31 eases of patients without thrombus （Group Normal）. The concentrations of P-sel, TpP and D-D in Group Thrombus increased obviously at the 1^st postoperative day, then gradually reduced after 7^th postoperative day. While there were nearly no change in that of the Group Normal. The difference was statistically significant （P〈0.05）. The highest specificity to predict postoperative portal vein thrombosis in the detection of three indicators at the 1~ postoperative day was P-sel, followed by D-D and TpP. The characteristics of the sensitivity showed TpP〉P-sel 〉D-D. And the misdiagnosis rate of P-sel was the lowest, with only 8.8%. Conclusion The postoperative P-sel, TpP and D-D concentration in patients with portal vein thrombosis surgery increases significantly at the 1^st postoperative day. And postoperative P-sel, TpP, D-D joint detection plays an auxiliary role in predicting the formation of portal vein thrombosis.