CAJ | 학술논문

目的：探讨P-选择素(P-sel)、血栓前体蛋白(TpP)和D-二聚体(D-D)联合检测预测门静脉高压症患者术后并发门静脉血栓的价值。方法选择2010年8月至2013年9月于我院行门静脉高压症手术的68例患者作为研究对象，患者分别于手术前后进行P-sel、TpP和D-D的含量检测，根据术后血栓发生与否进行分组，并对检测结果进行比较分析。结果患者术后发生血栓37例(血栓组)，未发生血栓31例(正常组)，术后1 d血栓组患者P-sel、TpP及D-D浓度均较术前明显升高，术后7 d逐渐降低，而正常组患者术后14 d内均无明显变化，差异具有统计学意义(P<0.05)。三项指标检测在术后第一天预测门静脉血栓形成方面特异性最高者为P-sel，其次为D-D、TpP，灵敏度表现为TpP>D-D＞P-sel的特点，且P-sel的误诊率最低，仅为8.8%。结论术后并发门静脉血栓患者大多术后第一天即可出现P-sel、TpP和D-D浓度显著升高，而术后P-sel、TpP和D-D三项的检测结果对预测门静脉血栓的形成具有辅助作用。
목적：탐토P-선택소(P-sel)、혈전전체단백(TpP)화D-이취체(D-D)연합검측예측문정맥고압증환자술후병발문정맥혈전적개치。방법선택2010년8월지2013년9월우아원행문정맥고압증수술적68례환자작위연구대상，환자분별우수술전후진행P-sel、TpP화D-D적함량검측，근거술후혈전발생여부진행분조，병대검측결과진행비교분석。결과환자술후발생혈전37례(혈전조)，미발생혈전31례(정상조)，술후1 d혈전조환자P-sel、TpP급D-D농도균교술전명현승고，술후7 d축점강저，이정상조환자술후14 d내균무명현변화，차이구유통계학의의(P<0.05)。삼항지표검측재술후제일천예측문정맥혈전형성방면특이성최고자위P-sel，기차위D-D、TpP，령민도표현위TpP>D-D＞P-sel적특점，차P-sel적오진솔최저，부위8.8%。결론술후병발문정맥혈전환자대다술후제일천즉가출현P-sel、TpP화D-D농도현저승고，이술후P-sel、TpP화D-D삼항적검측결과대예측문정맥혈전적형성구유보조작용。
Objective To discuss the predictive value of joint detection with P-sel, TpP, D-D for portal vein thrombosis in patients with portal hypertension surgery. Methods We selected 68 patients who had portal hyperten-sion surgery in our hospital (time limited from August 2010 to September 2013) as research subjects, and tested the content of P-sel, TpP and D-D respectively before and after surgery. The subjects we divided into Group Normal and Group Thrombus according to their occurrence of postoperative thrombosis, then the test results were analyzed. Results After the surgery, there were 37 cases of patients with thrombus (Group Thrombus) and other 31 cases of pa-tients without thrombus (Group Normal). The concentrations of P-sel, TpP and D-D in Group Thrombus increased ob-viously at the 1st postoperative day, then gradually reduced after 7th postoperative day. While there were nearly no change in that of the Group Normal. The difference was statistically significant (P<0.05). The highest specificity to predict postoperative portal vein thrombosis in the detection of three indicators at the 1st postoperative day was P-sel, followed by D-D and TpP. The characteristics of the sensitivity showed TpP>P-sel>D-D. And the misdiagnosis rate of P-sel was the lowest, with only 8.8%. Conclusion The postoperative P-sel, TpP and D-D concentration in patients with portal vein thrombosis surgery increases significantly at the 1st postoperative day. And postoperative P-sel, TpP, D-D joint detection plays an auxiliary role in predicting the formation of portal vein thrombosis.