Department of General Surgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong Province, China.
Thromb Res. 2010 May;125(5):e206-9. doi: 10.1016/j.thromres.2009.12.012. Epub 2010 Jan 15.
To investigate the predictive value of combined use of D-dimer and P-selectin for splenic or portal vein thrombosis (SPVT) after splenectomy. A prospective study was carried out in 82 patients who had undergone splenectomy for portal hypertension secondary to hepatic cirrhosis. Plasma levels D-dimer and P-selectin were measured before and after the surgery.27 (30.1%) patients developed SPVT following the portal hypertension surgery. The post-operative D-dimer and P-selectin levels in patients with SPVT were significantly higher than in those without PVT (n=55, P<0.01). The receiver-operated characteristics curves (ROC) of D-dimer and P-selectin showed a significant predictive value in SPVT (D-dimer, Az=0.880, P<0.01; P-slectin, Az=0.933, P<0.01). The sensitivity and specificity of D-dimer (>500 microg/mL) in diagnosing SPVT were 88.9% and 78.2% respectively. P-selectin >90ng/mL had an 85.2% sensitivity and 85.5% specificity for SPVT. The combination of the D-dimer and P-selectin criteria yielded an 82.0% sensitivity and 97.6% specificity for SPVT. In Conclusion, there was a significant elevation in plasma D-dimer and P-selectin in patients with post-operative SPVT. A combination of plasma D-dimer and P-selectin may be used as biomarkers to screen or diagnose SPVT following splenectomy.
为了研究 D-二聚体和 P-选择素联合应用对肝硬化门静脉高压症脾切除术后脾静脉或门静脉血栓形成（SPVT）的预测价值。对 82 例行脾切除术治疗门静脉高压症的患者进行了前瞻性研究。分别在手术前后测量了患者血浆 D-二聚体和 P-选择素水平。27 例（30.1%）患者在门静脉高压症手术后发生 SPVT。SPVT 患者术后 D-二聚体和 P-选择素水平明显高于无 PVT 患者（n=55，P<0.01）。D-二聚体和 P-选择素的受试者工作特征曲线（ROC）分析显示对 SPVT 有显著的预测价值（D-二聚体，Az=0.880，P<0.01；P-选择素，Az=0.933，P<0.01）。D-二聚体（>500μg/mL）诊断 SPVT 的敏感性和特异性分别为 88.9%和 78.2%。P-选择素（>90ng/mL）对 SPVT 的敏感性和特异性分别为 85.2%和 85.5%。D-二聚体和 P-选择素联合标准对 SPVT 的敏感性和特异性分别为 82.0%和 97.6%。总之，术后 SPVT 患者的血浆 D-二聚体和 P-选择素水平显著升高。联合检测血浆 D-二聚体和 P-选择素可作为筛选或诊断脾切除术后 SPVT 的生物标志物。
