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低分子肝素预防原发性肝癌切除术后静脉血栓栓塞及其与 P-选择素、溶酶体颗粒糖蛋白、血小板激活因子和血浆 D-二聚体的关系。

Prevention of venous thromboembolism after resection of primary liver cancer with low molecular weight heparin and its association with P-selectin, lysosomal granule glycoprotein, platelet activating factor and plasma D-dimer.

机构信息

Interventional Medicine Center, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

出版信息

Eur Rev Med Pharmacol Sci. 2018 Jul;22(14):4657-4662. doi: 10.26355/eurrev_201807_15525.

Abstract

OBJECTIVE

We aimed at analyzing the efficacy of low molecular heparin in the prevention of venous thromboembolism (VTE) after resection of primary liver cancer and at exploring the correlation of VTE with P-selectin (CD62P), lysosomal granule glycoprotein (CD63), platelet activating factor (PAF) and plasma D-dimer (D-D).

PATIENTS AND METHODS

A total of 233 patients treated with primary liver cancer resection in our hospital from February 2014 to October 2016 were enrolled in this study. The patients were randomly divided into the observation group (n=117) and the control group (n=116). The observation group received a subcutaneous injection of low molecular weight heparin at 2-7 days after surgery, and the control group was not treated with anticoagulation. The prevalence of VTE and the changes of CD62P, CD63, PAF, and D-D before and after treatment were compared between the two groups. The VTE prevalence after surgery, the changes of CD62P, CD63, PAF, D-D before and after surgery and the correlation of the above indexes with VTE were analyzed.

RESULTS

The prevalence of VTE in the observation group was 0.85% (1/117), which was lower than that of the control group (13.79%) (16/116); the difference was statistically significant (p<0.05). There was no significant difference in blood coagulation function between the two groups before and after operation (p>0.05). The CD62P, CD63, PAF, and D-D of the two groups were continuously decreased after the operation, and the serum CD62P, CD63 and plasma D-D of the observation group 6 d and 10 d after operation were lower than that of the control group; the difference was statistically significant (p<0.05). The serum CD62P, CD63 and plasma D-D in the VTE group 6 d and 10 d after operation were lower than those in the non-VTE group; the differences were statistically significant (p<0.05).

CONCLUSIONS

Low molecular weight heparin can effectively prevent VTE after primary liver cancer resection. Regularly monitoring CD62P, CD63, PAF, and D-D in patients after the operation is pivotal for early diagnosis, evaluation and treatment of VTE.

摘要

目的

分析低分子肝素预防原发性肝癌切除术后静脉血栓栓塞症(VTE)的疗效,并探讨 VTE 与 P-选择素(CD62P)、溶酶体颗粒糖蛋白(CD63)、血小板激活因子(PAF)和血浆 D-二聚体(D-D)的相关性。

患者与方法

选取 2014 年 2 月至 2016 年 10 月我院收治的原发性肝癌切除术患者 233 例,随机分为观察组(n=117)和对照组(n=116)。观察组患者术后 2-7 天皮下注射低分子肝素,对照组患者不进行抗凝治疗。比较两组患者 VTE 发生率及治疗前后 CD62P、CD63、PAF、D-D 的变化,分析术后 VTE 发生率、CD62P、CD63、PAF、D-D 变化与 VTE 的相关性。

结果

观察组 VTE 发生率为 0.85%(1/117),低于对照组的 13.79%(16/116),差异有统计学意义(p<0.05)。两组患者手术前后凝血功能比较,差异无统计学意义(p>0.05)。两组患者术后 CD62P、CD63、PAF、D-D 均逐渐下降,观察组术后 6d、10d 时血清 CD62P、CD63 及血浆 D-D 低于对照组,差异有统计学意义(p<0.05)。VTE 组患者术后 6d、10d 时血清 CD62P、CD63 及血浆 D-D 低于非 VTE 组,差异有统计学意义(p<0.05)。

结论

低分子肝素可有效预防原发性肝癌切除术后 VTE,术后定期监测患者 CD62P、CD63、PAF、D-D 对 VTE 的早期诊断、评估及治疗具有重要意义。

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