D-二聚体对膀胱癌术后感染的诊断价值  

Value of D-dimer in diagnosis of bladder cancer patients with postoperative infection

作　　者：张良[1] 马国英[1] 郑媛媛[1] 董春忠[1] 王月玲[2] ZHANG Liang;MA Guo-ying;ZHENG Yuan-yuan;DONG Chun-zhong;WANG Yue-ling(Binzhou People Unciefineds Hospital Binzhou Shandong 256600,China)

机构地区：[1]山东省滨州市人民医院检验科,山东滨州256600 [2]山东省立医院检验科,山东济南250021

出　　处：《中华医院感染学杂志》2019年第22期3440-3443,3447,共5页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展计划基金资助项目(2014WS0081)

摘　　要：目的探讨分析D-二聚体检测对膀胱癌术后感染的诊断价值及与预后的关系,为膀胱癌术后感染患者早期诊断和治疗提供依据。方法选择2011年5月-2014年6月在山东省滨州市人民医院接受膀胱癌根治术治疗的浅表性膀胱癌患者317例,按照术后是否发生感染分为感染组和未感染组,比较两组患者术后3 d血浆D-二聚体水平,采用受试者工作特征曲线(ROC)分析D-二聚体对患者术后感染的预测价值,采用Kaplan-Meier生存曲线分析D-二聚体对患者术后生存的影响。结果317例膀胱癌患者中,发生术后感染患者55例,术后感染发生率为17.35%。55例术后感染患者共分离病原菌63株,其中革兰阴性菌39株(占61.90%)、革兰阳性菌18例(28.57%)、真菌6株(9.52%)。感染组患者血浆D-二聚体水平高于未感染组(P<0.05)。ROC曲线下面积为0.784。生存情况分析显示,D-二聚体水平<3.0 mg/L患者术后生存情况优于D-二聚体水平≥3.0 mg/L患者(P<0.05)。结论血浆D-二聚体水平检测可作为膀胱癌术后诊断的指标之一,同时对预测患者术后生存预后具有着一定的价值,值得临床推广。OBJECTIVE To explore the value of D-dimer in diagnosis of the bladder cancer patients with postoperative infection and analyze its correlation with prognosis so as to provide guidance for early diagnosis and treatment of the bladder cancer patients with postoperative infection.METHODS A total of 317 patients with superficial bladder cancer who underwent radical resection of bladder cancer in Binzhou People Undefineds Hospital from May 2011 to Jun 2014 were enrolled in the study and divided into the infection group and the non-infection group according to the status of postoperative infection.The level of plasma D-dimer was compared between the two groups of patients after the surgery for 3 days,the value of D-dimer in prediction of postoperative infection was analyzed by using receiver-operating-characteristic(ROC)curve,and the effect of D-dimer on postoperative survival of the patients was observed by means of Kaplan-Meier survival curve.RESULTS Of the 317 patients with bladder cancer,55 had postoperative infection,with the incidence rate of postoperative infection 17.35%.Totally 63 strain of pathogens were isolated from the 55 patients with postoperative infection,39(61.90%)of which were gram-negative bacteria,18(28.57%)were gram-positive bacteria,and 6(9.52%)were fungi.The plasma D-dimer level of the infection group was significantly higher than that of the non-infection group(P<0.05).The area under ROC curve was 0.784.The analysis of survival showed that the patients with the D-dimer level less than 3.0 mg/L had significantly better postoperative survival than the patients with the D-dimer level no less than 3.0 mg/L(P<0.05).CONCLUSION The plasma D-dimer can be used an index for diagnosis of postoperative infection in the bladder cancer patients and has certain value in prediction of prognosis of the patients,and it is worthy to be promoted in the hospital.

关 键 词：D-二聚体 膀胱癌 术后感染 诊断 预后 

分 类 号：R73[医药卫生—肿瘤]