终末期恶性肿瘤患者血浆D二聚体动态变化及意义  

Clinical Significanc of Plasma D-dimer Dynamic Changes in End-Stage Malignant Patients

作　　者：黎金庆 黎牧郴 丛龙皎 胡乃东[1] LI Jinqing;LI Mu-jchen;CONG Long-jiao;HU Nai-dong(Dept.of Hematoncology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 101100,China;Dept.of Gastroenterology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 101100,China;Dept.of Pulmonsry,Chaoyang Hospital,Capital Medicine University,Beijing 100020,China)

机构地区：[1]北京中医药大学东直门医院血液肿瘤科,北京101100 [2]北京中医药大学东直门医院脾胃科,北京101100 [3]北京首都医科大学朝阳医院呼吸科,北京100020

出　　处：《血栓与止血学》2021年第3期374-376,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的了解终末期恶性肿瘤患者血浆D二聚体(D-D)动态变化、探讨其临床意义。方法观察组125例,均为终末期恶性肿瘤患者,回顾性分析死亡前0~14天内血浆D-D水平,无肿瘤的肠息肉患者63例为照组。15例终末期恶性肿瘤患者死亡前-4周、-3周、-2周、-1周连续测定了血浆D-D,动态分析其变化。结果观察组死亡前14 d内的血浆D-D水平明显高于对照组(P<0.0001);死亡前3周内的血浆D-D呈进行性动态升高,基本都在正常值上限10倍以上。结论终末期恶性肿瘤患者血浆D-D水平明显升高,血栓形成可能使病情更加复杂化,促进死亡过程。血浆D-D水平高于正常值上限10倍以上,应作为危急值引起临床医生注意,进行必要的处理。Objective To observe the dynamic changes of plasma D-dimer in end-stage malignant patients and to evaluate its meaning in clinical management.Methods Plasma D-dimer concentration was detected in 125 cases of end-stage malignant patients at the interval of-14 day to death time.63 cases of intestinal polyp patients with exclusion of malignant neoplasm were used as control.To obtain the dynamic changes of plasma D-dimer,15 out of 125 malignant patients with continuous plasma D-dimer detection at the-4,-3,-2 and-1 week was analyzed.Results Plasma D-dimer concentration at the interval between-14 days and death time in end-stage malignant patients was significantly higher as compared with that in the control group(P<0.0001).From-3 week to the death day,Plasma D-dimer level was dynamically increased and the concentration was almost 10 folds higher than the upper limit of normal range.Conclusion The end-stage malignant patients had significantly higher plasma D-dimer level.Dynamic increase of plasma D-dimer concentration with 10 times higher than upper limit of normal range may be a risk factor,which may necessitate prompt and effective management.

关 键 词：血浆D二聚体 恶性肿瘤 终末期 

分 类 号：R446[医药卫生—诊断学]