2022 年第 3 期 第 17 卷

血浆D-二聚体和C反应蛋白水平与乳腺癌患者输液港相关深静脉血栓形成的相关性分析

Correlation analysis of plasma D-dimer, C-reactive protein level and deep vein thrombosis associated with infusion port in patients with breast cancer

作者：张燕群边冬梅赵新娟吴宇佼易成刚曹辉

英文作者：Zhang Yanqun Bian Dongmei Zhao Xinjuan Wu Yujiao Yi Chenggang Cao Hui

单位：空军军医大学第一附属医院急诊科，西安710032

英文单位：Department of Emergency the First Affiliated Hospital of Air Force Medical University Xi′an 710032 China

关键词：乳腺癌；输液港；血栓；D-二聚体；C反应蛋白

英文关键词：Breastcancer;Infusionport;Thrombus;D-dimer;C-reactiveprotein

• 摘要：

• 目的 分析血浆D-二聚体和C反应蛋白（CRP）水平与乳腺癌患者输液港相关深静脉血栓形成的相关性，探讨D-二聚体、CRP对乳腺癌患者输液港相关深静脉血栓形成的诊断价值。方法  选择2019年3月至2021年6月空军军医大学第一附属医院收治的183例采用植入式静脉输液港化疗的乳腺癌患者，根据是否发生输液港相关深静脉血栓将患者分为血栓组（47例）和无血栓组（136例）。检测2组血浆D-二聚体、CRP水平，分析D-二聚体、CRP与乳腺癌患者发生输液港相关深静脉血栓的关系以及D-二聚体、CRP诊断输液港相关深静脉血栓的价值。结果 血栓组血浆D-二聚体、CRP水平高于无血栓组［（1.12±0.36）mg/L比（0.38±0.16）mg/L、（26.35±6.09）mg/L比（12.05±3.14）mg/L］，差异均有统计学意义（均P＜0.001）。多因素Logistic回归分析结果显示既往静脉血栓病史、长期卧床、高水平D-二聚体、高水平CRP是乳腺癌患者发生输液港相关深静脉血栓的危险因素（比值比=1.865，95%置信区间：1.252～2.776，P=0.015；比值比=1.353，95%置信区间：1.004～1.822，P=0.003；比值比=1.510，95%置信区间：1.051～2.170，P=0.020；比值比=1.813，95%置信区间：1.284～2.600，P=0.012）。D-二聚体、CRP诊断乳腺癌患者发生输液港相关深静脉血栓的曲线下面积为0.628、0.736，CRP略高于D-二聚体（Z=2.560，P＜0.05），联合D-二聚体和CRP诊断乳腺癌患者发生输液港相关深静脉血栓的曲线下面积为0.894，高于二者单独诊断（均P＜0.05）。结论  血浆D-二聚体和CRP水平升高与乳腺癌患者输液港相关深静脉血栓形成密切相关，联合D-二聚体和CRP可提高对输液港相关深静脉血栓的诊断效能。

• Objective   To investigate the correlation between plasma D-dimer, C-reactive protein (CRP) levels and deep vein thrombosis (DVT) associated with infusion port in patients with breast cancer, and to analyze the value of D-dimer and CRP in the diagnosis of DVT associated with infusion port in breast cancer. Methods   From March 2019 to June 2021, 183 patients wiht breast cancer admitted to the First Affiliated Hospital of Air Force Medical University who received intravenous infusion port chemotherapy were enrolled. They were divided into thrombus group (47 cases) and non-thrombus group (136 cases) according to the occurrence of DVT associated with infusion port. Levels of plasma D-dimer and CRP were detected to analyze the relationship with DVT associated with infusion port in patients with breast cancer, and the value of D-dimer and CRP in the diagnosis of DVT associated with infusion port. Results  The levels of plasma D-dimer and CRP in the thrombus group were higher than those in the non-thrombus group［（1.12±0.36）mg/L vs （0.38±0.16）mg/L,（26.35±6.09）mg/L vs （12.05±3.14）mg/L］(both P＜0.001). Multivariate Logistic regression analysis showed that venous thrombosis history, long-term bed rest, high level of D-dimer and high level of CRP were the risk factors for DVT associated with infusion port in patients with breast cancer (odds ratio=1.865, 95% confidence interval: 1.252-2.776, P=0.015; odds ratio=1.353, 95% confidence interval: 1.004-1.822, P=0.003; odds ratio=1.510, 95% confidence interval: 1.051-2.170, P=0.020; odds ratio=1.813, 95% confidence interval: 1.284-2.600, P=0.012). The area under the curve of D-dimer and CRP were 0.628 and 0.736 in diagnosing DVT associated with infusion port in patients with breast cancer, and CRP was slightly higher than D-dimer (Z=2.560, P＜0.05). The area under the curve of D-dimer combined with CRP was 0.894, which was higher than those single diagnosis (both P＜0.05). Conclusions The elevated levels of D-dimer and CRP in plasma are closely related to DVT associated with infusion port in patients with breast cancer, and the combination of D-dimer and CRP can improve the diagnostic efficiency on DVT associated with infusion port.