终末期恶性肿瘤患者血浆D二聚水平与肝功能损害的关系  

Association of Plasma D-dimer Level in End-Stage Malignant Patients with Liver Function Damage

作　　者：黎金庆 黎牧郴 石憧娈 丛龙皎 胡乃东[1] LI Jin-qing;LI Mu-chen;SHI Chon-luan;CONG Long-jiao;HU Nai-dong(Dept.of Hematoncology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,101100,China;Dept of Pulmonary and Critical Care Medicine,Capital Medical University,Beijing,100020,China;Dept of Obstetrics and Gynecology,Chaoyang Hospital,Capital Medical University,Beijing,100020,China;Dept.of Gastroenterology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,101100,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]北京首都医科大学朝阳医院呼吸科,北京100020 [3]北京首都医科大学朝阳医院妇产科,北京100020 [4]北京中医药大学东直门医院脾胃科,北京101100

出　　处：《血栓与止血学》2021年第6期917-919,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的了解终末期恶性肿瘤患者微血栓形成和血浆D二聚体(D-D)是否受肝功能状态影响。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;无肿瘤肠息肉患者63例为照组。观察组病例中,根据血清丙氨酸转氨酶、总胆红素水平大于正常上限值2倍以上为肝损害亚组,分别比较肝损害与否对血浆D-D的影响。再根据肝功能Child-Pugh分级,比较不同级别肝功能贮备状态的血浆D-D水平。结果终末期恶性肿瘤患者血浆D二聚体水平明显高于对照组,血清丙氨酸转移酶大于2倍以上和低于2倍以下的肿瘤患者血浆D-D水平无明显差别(P>0.05);血清胆红素水平大于2倍以上和低于2倍以下的肿瘤患者血浆D-D水平也无明显差别(P>0.05);肝功能Child-Pugh分级中,A、B和C三个级别的恶性肿瘤患者血浆D-D水平相似(P>0.05)。结论终末期恶性肿瘤血浆D-D明显升高,在不同的肝功能贮备状态下,其血浆D-D水平相似,提示恶性肿瘤微血栓形成并不受肝功能状态的影响,肝损害不影响癌症患者微血栓形成和血浆D-D水平。Objective To understand whether venous thrombosis and plasma D-dimer(D-D)level in end-stage malignant patients are affected by liver function.Methods Plasma D-D 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.Subgroup patients were made according to serum alanine aminotransferase and total bilirubin level in 125 cases of end-stage malignant patients.Serum level of alanine aminotransferase or bilirubin higher than 2 fold normal limit was defined as liver function damage.Plasma D-D level in patients with or without liver damage was comparied.Grade A,B and C liver function reserve was made according to Child-Pugh score and plasma D-D level in patients with different score was assessed.Results Plasma D-D level in end-stage malignant patients was significantly higher as compared with that in the control group(P<0.0001).No difference was observed between liver-damage and no-liver-damage subgroup as judged by serum alanine aminotransferase level(P>0.05).Similar results was also seen as by serum bilirubin level(P>0.05).There were no significance difference in plasma D-D level between subgroup with A,B and C Child-Pugh score(P>0.05).Conclusion There was significantly higher plasma D-D level in end-stage malignant patients.Plasma D-D level,pointing to thrombosis,was not affected by liver function status.

关 键 词：血浆D二聚体 恶性肿瘤 终末期 肝功能损害 

分 类 号：R973[医药卫生—药品]