Dai Junna, Qi Xingshun, Peng Ying, Hou Yue, Chen Jiang, Li Hongyu, Guo Xiaozhong
Postgraduate College, Dalian Medical University Dalian, Liaoning, P.R. China.
Liver Cirrhosis Group, Department of Gastroenterology, General Hospital of Shenyang Military Area Shenyang 110840, P.R. China.
Int J Clin Exp Med. 2015 Sep 15;8(9):15296-301. eCollection 2015.
This study aimed to explore the association between D-dimer levels and presence of portal venous system thrombosis (PVST) in liver cirrhosis.
All consecutive patients with a diagnosis of liver cirrhosis who underwent D-dimer test were retrospectively enrolled. Normal reference range of D-dimer level was 0-0.3 µg/mL. PVST was diagnosed on the basis of contrast-enhanced computed tomography and/or magnetic resonance imaging scans.
Of the 66 included patients, 24 were diagnosed with PVST. Mean D-dimer level was 0.51±0.72 µg/mL (range: 0.10-3.44). Mean D-dimer level was not significantly different between PVST and non-PVST groups (0.68±0.93 µg/mL versus 0.41±0.56 µg/mL, P=0.146). Area under the receiver operating curve for D-dimer level for predicting the presence of PVT was 0.606 (95% confidence interval: 0.478-0.724, P=0.1393). The optimal cut-off value for D-dimer was 0.22 with a sensitivity of 58.3% and a specificity of 69.0%. The subgroup analyses of patients without splenectomy or those with different Child-Pugh classes demonstrated no significant difference in the D-dimer level between PVST and non-PVST groups.
D-dimer might not be useful to identify the presence of PVST in liver cirrhosis. However, given the retrospective nature of this study, further well-designed prospective study should be necessary to confirm this finding.
本研究旨在探讨D - 二聚体水平与肝硬化患者门静脉系统血栓形成(PVST)之间的关联。
回顾性纳入所有连续诊断为肝硬化且接受D - 二聚体检测的患者。D - 二聚体水平的正常参考范围为0 - 0.3μg/mL。PVST根据增强计算机断层扫描和/或磁共振成像扫描进行诊断。
在纳入的66例患者中,24例被诊断为PVST。平均D - 二聚体水平为0.51±0.72μg/mL(范围:0.10 - 3.44)。PVST组和非PVST组的平均D - 二聚体水平无显著差异(0.68±0.93μg/mL对0.41±0.56μg/mL,P = 0.146)。D - 二聚体水平预测PVT存在的受试者工作特征曲线下面积为0.606(95%置信区间:0.478 - 0.724,P = 0.1393)。D - 二聚体的最佳截断值为0.22,敏感性为58.3%,特异性为69.0%。未行脾切除术的患者或不同Child - Pugh分级患者的亚组分析显示,PVST组和非PVST组之间的D - 二聚体水平无显著差异。
D - 二聚体可能无助于识别肝硬化患者中PVST的存在。然而,鉴于本研究的回顾性性质,有必要进行进一步精心设计的前瞻性研究来证实这一发现。