血浆指标与骨肉瘤术后深静脉血栓的相关分析  

Correlation between blood parameters and deep vein thrombosis secondary to surgical treatment for osteosarcoma

作　　者：周威[1] 陈贡斌[1] 刘海燕[1] 郭银谋[1] 林全德[2] ZHOU Wei;CHEN Gong-bin;LIU Hai-yan;GUO Yin-mou;LIN Quan-de(Department of Oncology,The First Peopled Hospital of Shangqiu City,Shangqiu 476100,China;Department of Oncology,Henan Provincial Cancer Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省商丘市第一人民医院肿瘤科,河南商丘476100 [2]河南省肿瘤医院肿瘤科,河南郑州450000

出　　处：《中国矫形外科杂志》2020年第21期1963-1967,共5页Orthopedic Journal of China

基　　金：2017年河南省科技研发项目(编号:162102310316)。

摘　　要：[目的]分析血浆中血管性血友病因子(vWF)及血管性血友病因子裂解酶(vWF-CP)与骨肉瘤患者术后发生深静脉血栓(DVT)的相关性。[方法]2016年3月~2019年6月,对83例骨肉瘤患者行新辅助化疗与手术治疗。评价术后血栓发生的相关因素。[结果]83例骨肉瘤患者中,术后发生DVT 28例,占33.73%;末发生DVT55例,占66.27%。发生DVT组的体质量指数(BMI)、骨水泥使用比率、血浆中vWF均显著高于未发生DVT组,而前者血浆vWF-CP显著低于后者(P<0.05)。逻辑回归分析表明,BMI(OR=2.255,P=0.003)、骨水泥(OR=2.085,P=0.004)、血浆vWF(OR=5.360,P<0.001)是血栓发生的危险因素,而血浆vWF-CP(OR=0.386,P<0.001)是术后发生DVT的保护因素。ROC结果表明,血浆vWF、vWF-CP单独及联合预测OS患者术后发生DVT的曲线下面积(AUC)分别为:0.732、0.757、0.816。[结论]BMI、骨水泥、血浆vWF、vWF-CP是OS患者术后发生DVT的相关因素,血浆vWF、vWF-CP联合检测对OS患者术后发生DVT预测价值较高。[Objective]To analyze the correlation between blood parameters,including von Willibrand factor(vWF)and von Willibrand factor-cleaving protease(vWF-CP),and deep vein thrombosis(DVT)secondary to surgical procedures for osteosarcoma.[Methods]From March 2016 to June 2019,83 patients underwent neoadjuvant chemotherapy and surgery for osteosarcoma.The factors related to occurrence of DVT after operation were searched.[Results]Of the 83 patients,28 were definitively diagnosed of DVT,accounting for 33.73%,while the remaining 55 patients had no DVT,accounting for 66.27%.The DVT group had significantly higher the body mass index(BMI),ratio of bone cement used and plasma vWF,whereas significantly lower vWF-CP than the non-DVT group(P<0.05).As results of multivariate logistic regression,the BMI(OR=2.255,P=0.003),bone cement used(OR=2.085,P=0.004)and plasma vWF(OR=5.360,P<0.001)were risk factors of DVT,whereas the plasma vWF-CP(OR=0.386,P<0.001)was protect factors for postoperative DVT,ROC results showed that the best cut-off points for plasma vWF and vWF-CP to predict postoperative DVT were 137.93%and 56.17%respectively.The area under curve(AUC)of plasma vWF,vWF-CP alone and the combination were 0.732,0.757 and 0.816 respectively.[Conclusion]BMI,bone cement,plasma vWF and vWF-CP are the factors related to postoperative DVT secondary to operation for osteosarcoma.The combination of plasma vWF and vWF-CP has a high predictive value for postoperative DVT.

关 键 词：骨肉瘤 深静脉血栓 血管性血友病因子 血管性血友病因子裂解酶 

分 类 号：R738[医药卫生—肿瘤]