同型半胱氨酸联合D-二聚体对肝癌血栓前状态监测的研究

目的探讨联合应用同型半胱氨酸（HCY）和D-二聚体（D-Dimer）对肝癌血栓前状态预测的临床应用价值。方法选取50例原发性肝癌患者（肝癌组），30例肝硬化患者（肝硬化组），30例健康对照组，检测血清HCY、血浆D-Dimer的水平，应用ROc曲线分析其对肝癌血栓前状态的预测价值。结果肝癌组与肝硬化组、健康对照组比较，血清HcY、D-Dimer水平均明显升高（P〈O．05）；肝硬化组与健康对照组比较，血清nDimer水平明显升高（P〈0．05），而HCY差异无统计学意义（P=0．912）。原发性肝癌患者的HCY、D-Dimer与两者联合检测在ROC曲线下的面积分别为0．902、0．846、0．941。HCY、D-Dimer对原发性肝癌血栓前状态的临床预测临界点分男11为13．28μmol／L、1451ng／mL。结论HCY和D-IDimer可以作为原发性肝癌血栓前状态的辅助诊断指标，两者联合应用可以提高对原发性肝癌血栓前状态的检出率。

Study of HCY combined with D-Dimer on monitoring of prethrombotic state in hepatocarcinoma patients

Objective To explore the predictive value of homocysteine（HCY）combined with D-Dimer in the prethrombotic state of primary hepatocarcinoma（PHC）. Methods 50 cases of primary liver cancer,30 cases of hepat- ic sclerosis and 30 cases of healthy human were selected,and the levels of HCY and D-Dimer were detected. The pre- dictive value was evaluated by ROC curve. Results The HCY and D-Dimer in the PHC group were significantly higher than that in hepatic sclerosis and control group（P〈0.05）. The D-Dimer level was significantly higher in he- patic sclerosis group than that in healthy human（P〈0.05） ,while there was no significance of HCY between the he patic sclerosis and the control group（P=0. 912）. The areas under ROC curve of HCY,D-Dimer and the joint detec- tion of the two indexes were 0. 902,0. 846 and 0. 941, respectively. The clinical predictive critical points of HCY and D-Dimer in PHC with prethrombotic state were 13.28μmol/L and 1 451 ng/mL,respectively. Conclusion The com- bination of the HCY and D-Dimer could predict the prethrombotic state of the primary hepatocarcinoma.