D-二聚体、纤维蛋白原和F1+2对卵巢癌术后并发静脉血栓栓塞的预测价值  

Predictive value of D-dimer,fibrinogen and F1+2 for postoperative venous thromboembolism in ovarian cancer

作　　者：曹梦杰 张驰裕 张斌 闫国贝 苏威强 CAO Mengjie;ZHANG Chiyu;ZHANG Bin;YAN Guobei;SU Weiqiang(Department of Clinical laboratory,The First Affiliated Hospital of Henan Polytechnic University,Jiaozuo 454000,China;Department of Ophthalmic Center,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Vascular Surgery,The First Affiliated Hospital of Henan Polytechnic University,Jiaozuo 454000,China)

机构地区：[1]河南理工大学第一附属医院检验科,焦作454000 [2]河北医科大学第二医院眼科,石家庄050000 [3]河南理工大学第一附属医院血管外科,焦作454000

出　　处：《济宁医学院学报》2025年第1期43-47,共5页Journal of Jining Medical University

基　　金：焦作市科技局科技攻关项目(202223034)。

摘　　要：目的探究卵巢癌术后并发静脉血栓栓塞(VTE)患者D-二聚体、纤维蛋白原(FBG)和凝血酶原片段1+2(F1+2)变化及临床意义。方法回顾性分析2021年1月—2023年12月我院收治的99例卵巢癌患者,根据是否发生VTE将患者分为VTE组和对照组(未发生VTE患者),分析并统计两组患者的临床数据。Spearman相关分别分析D-二聚体与FBG和F1+2的相关性;二元logistics回归分析卵巢癌术后并发VTE的影响因素;受试工作者(ROC)曲线分析D-二聚体、FBG和F1+2对于卵巢癌发生VTE的预测价值。结果卵巢癌术后并发VTE组红细胞[(3.49±0.47)×10^(12)/L]、血红蛋白[(106.88±15.45)g/L]低于对照组[(3.99±0.63)×10^(12)/L、(119.86±18.31)g/L,P<0.05];而D-二聚体[(3.35±1.17)mg/L]、FBG[(3.85±0.21)g/L]、F1+2[(267.44±62.18)pmol/L]均高于对照组[(0.45±0.11)mg/L、(2.90±0.14)g/L、(186.52±45.61)pmol/L,P<0.05];D-二聚体与F1+2呈正相关(r=0.433,P<0.05);二元logistic回归分析结果显示D-二聚体(OR=2.485,95%CI=1.428~4.322)、FBG(OR=2.376,95%CI=1.011~5.540)和F1+2(OR=1.015,95%CI=1.001~1.03)为卵巢癌术后并发VTE的独立危险因素;D-二聚体、FBG和F1+2预测卵巢癌术后并发VTE的曲线下面积分别为0.896、0.689、0.841;D-二聚体联合F1+2的AUC为0.911。结论卵巢癌术后并发VTE患者的D-二聚体、FBG和F1+2水平升高,且异常升高均为VTE发生的独立危险因素,这些指标对VTE的发生均有预测价值,联合三者的预测价值更高。Objective To explore the changes and clinical significance of D-dimer,fibrinogen(FBG)and prothrombin fragment 1+2(F1+2)in patients with postoperative venous thromboembolism(VTE)after ovarian cancer surgery.Methods A retrospective analysis was conducted on 99 ovarian cancer patients admitted to our hospital from January 2021 to December 2023.Patients were divided into VTE group and non-VTE group according to whether VTE occurred.Clinical data of the two groups were analyzed and counted.Spearman correlation analysis was used to assess the relationships between D-dimer and FBG and F1+2 respectively.Binary logistics regression analyzsis was performed to identify risk factors affecting VTE in ovarian cancer.Receiver operating charaoteristic(ROC)curve analyzed the predictive value of D-dimer,FBG and F1+2 for VTE in ovarian cancer.Results In the DTE group,the red blood cells[(3.49±0.47)×10^(12)/L]and hemoglobin[(106.88±15.45)g/L]were lower than those in the control group[(3.99±0.63)×10^(12)/L,(119.86±18.31)g/L,P<0.05];Meanwhile the D-dimer[(3.35±1.17)mg/L],FBG[(3.85±0.21)g/L],F1+2[(267.44±62.18)pmol/L]are higher than the control group[(0.45±0.11)mg/L,(2.90±0.14)g/L,(186.52±45.61)pmol/L,P<0.05];D-dimer was positively associated with F1+2,(r=0.433,P<0.05);The binary logistic regression analysis showed that D-dimer(OR=2.485,95%CI=1.428~4.322),FBG(OR=2.376,95%CI=1.011~5.540)and F1+2(OR=1.015,95%CI=1.001~1.03)is an independent risk factor for concurrent VTE after ovarian cancer surgery;The area under the curve of D-dimer,FBG and F1+2 for predicting concurrent VTE after ovarian cancer surgery was 0.896,0.689 and 0.841,respectively;The AUC of the D-dimer in combination with F1+2 was 0.911.Conclusions The levels of D-dimer,FBG and F1+2,and the abnormal increase are all independent risk factors for VTE.These indicators have predictive value for the occurrence of VTE,and the predictive value of combining the three is higher.

关 键 词：D-二聚体 纤维蛋白原 凝血酶原片段1+2 卵巢癌 静脉血栓栓塞 肺栓塞 

分 类 号：R737.31[医药卫生—肿瘤]