Fei Yang, Zong Guang-Quan, Chen Jian, Liu Ren-Min
Department of General Surgery, the 81st Hospital of P.L.A., P.L.A. Cancer Center, Nanjing, China.
Department of General Surgery, the 81st Hospital of P.L.A., P.L.A. Cancer Center, Nanjing, China
Clin Appl Thromb Hemost. 2016 Jul;22(5):471-5. doi: 10.1177/1076029615569273. Epub 2015 Jan 29.
BACKGROUND/AIM: To evaluate the value of d-dimer, P-selectin, and platelet count in patients with cirrhotic portal hypertension (PHT) for prediction of portal vein thrombosis (PVT) after devascularization.
A total of 137 patients with cirrhotic PHT who undergone devascularization from January 2012 to April 2014 were retrospectively reviewed, all of them were divided into 2 groups (PVT group and non-PVT group) by Doppler ultrasonography (DU) examination. The level of d-dimer, P-selectin, and platelet count was tested during the perioperative period.
In all, 38 (27.7%) patients were found to have PVT by DU examination postoperatively. In contrast to the non-PVT group, the level of d-dimer, P-selectin, and platelet count in the PVT group was much higher significantly at 1, 3, and 7 days after devascularization. (P < .05). However, in the 15 days after surgery, the difference in P-selectin between the 2 groups was not significant (P = .260). It was shown that the highest sensitivity of the 3 markers for PVT was d-dimer, the highest specificity belonged to P-selectin. The area under receiver-operating characteristic (ROC) curve of P-selectin was the biggest of the 3 markers. When the 3 markers were combined to be used to diagnose PVT, the sensitivity was increased to 0.907, with a slight drop of specificity to 0.693, the area under the ROC curve was 0.927.
The level of d-dimer, P-selectin, and platelet count might be good candidate predictive markers for PVT in patients with cirrhotic PHT after devascularization. The combined test of the 3 markers can increase the value of prediction.
背景/目的：评估D-二聚体、P-选择素和血小板计数在肝硬化门静脉高压症（PHT）患者中对去血管化后门静脉血栓形成（PVT）的预测价值。
回顾性分析2012年1月至2014年4月期间接受去血管化治疗的137例肝硬化PHT患者，所有患者均通过多普勒超声（DU）检查分为两组（PVT组和非PVT组）。在围手术期检测D-二聚体、P-选择素和血小板计数水平。
术后通过DU检查发现，共有38例（27.7%）患者发生PVT。与非PVT组相比，PVT组在去血管化后1、3和7天时D-二聚体、P-选择素和血小板计数水平显著更高（P <.05）。然而，术后15天时，两组之间P-选择素的差异不显著（P =.260）。结果显示，这3种标志物对PVT的最高敏感性为D-二聚体，最高特异性属于P-选择素。P-选择素的受试者操作特征（ROC）曲线下面积在这3种标志物中最大。当联合使用这3种标志物诊断PVT时，敏感性提高到0.907，特异性略有下降至0.693，ROC曲线下面积为0.927。
D-二聚体、P-选择素和血小板计数水平可能是肝硬化PHT患者去血管化后PVT的良好候选预测标志物。这3种标志物的联合检测可提高预测价值。
