进展期胆管癌患者静脉血栓栓塞症的发生及临床意义

摘要/Abstract

摘要： 目的分析进展期胆管癌患者静脉血栓栓塞症的发生及临床意义。方法 2019年3月至2020年3月泰州市第四人民医院收治的进展期胆管癌患者65例,根据是否发生静脉血栓栓塞症分为发生组(n=35)和未发生组(n=30)。所有患者在入院后接受实验室检查、彩超检查和Caprini量表评估,对两组各项指标进行单因素分析,多因素logistic回归分析进展期胆管癌患者静脉血栓栓塞症发生的危险因素。结果发生组的血小板、D-二聚体和纤维蛋白原水平为(419.4±102.5)×10⁹/L、(2.9±1.3)mg/L、(9.8±2.6)mg/L,高于未发生组的(302.1±25.6)×10⁹/L、(1.8±1.2)mg/L、(7.5±1.8)mg/L,发生组抗凝血酶Ⅲ水平为(72.9±8.5)%,低于未发生组的(98.2±25.8)%,差异有统计学意义(P<0.05)。血小板、D-二聚体、纤维蛋白原、γ-谷氨酰转移酶、抗凝血酶Ⅲ、Caprini>3分、彩超检查阳性是进展期胆管癌患者静脉血栓栓塞症发生的独立危险因素(OR=4.577、4.702、5.018、4.797、5.114、4.674、5.038,P<0.05)。结论血小板、抗凝血酶Ⅲ、D-二聚体、纤维蛋白原、Caprini量表、彩超检查可在一定程度上预测静脉血栓栓塞症的发生。

关键词: 进展期, 胆管癌, 静脉血栓栓塞症, 临床意义

Abstract: Objective To investigate the incidence and clinical implications of venous thromboembolism in patients diagnosed with advanced cholangiocarcinoma. Methods From March 2019 to March 2020, Sixty-five patients with clinicopathologically confirmed advanced cholangiocarcinoma were admitted to our hospital. These patients were categorized into two groups based on the occurrence of venous thromboembolism: and occurrence group (n=35) and a non-occurrence group (n=30). Post-admission, all patients underwent laboratory testing, routine blood examinations, lower limb deep vein ultrasound, and Caprini scale assessments, A univariate analysis of indicators from both groups was conducted, followed by a multicariate logistic regression analysis of variables that exhibited statistically significant differences in the univariate analysis. This approach aimed to identify risk factors associated with the development of venous thromboembolism in patients with cholangiocarcinoma. Results The univariate analysis revealed that the occurence group demonstrated significantly higher levels of platelet, D-dimer and fibrinogen, with values of (419.4 ± 102.5) × 10⁹/L, (2.9 ± 1.3) mg/L, and (9.8 ± 2.6) mg/L, respectively, compared to the non-occurrence group, which showed levels of (302.1 ± 25.6) × 10⁹/L, (1.8 ± 1.2) mg/L, (7.5 ± 1.8 ) mg/L. Furthermore, the antithrombin III level in the occurrence group was significantly lower at (72.9±8.5)%, compared to (98.2±25.8)% in the non-occurrence group (P<0.05). The multifactorial logistic regression analysis identified platelets, D-dimer, fibrinogen, antithrombin III, caprini assessment results, and findings from lower extremity deep vein ultrasound as independent risk factors for venous thromboembolism in patients with cholangiocarcinoma, with odds ratios(OR) of 4.577, 4.702, 5.018, 4.797, 5.114, 4.674, and 5.038, respectively(P<0.05). Conclusion Patients with advanced cholangiocarcinoma are identified as having a high incidence of venous thromboembolism. In such patients, factors including platelet count, antithrombin III levels, D-dimer, fibrinogen, Caprini scale ratings, and ultrasound examinations have been found to predict the occurrence of venous thromboembolism to a significant extent. These parameters not only aid in anticipating venous thromboembolism but also serve as crucial clinical tools for confirming its presence in patients with advanced cholangiocarcinoma. Consequently, the results from these tests are instrumental in the clinical diagnosis of venous thromboembolism in this patient population.

Key words: Progressive stage, Cholangiocarcinoma, Venous thromboembolism, Incidence, Clinical implications

孙根林, 王娜娜, 鲍扬漪. 进展期胆管癌患者静脉血栓栓塞症的发生及临床意义[J]. 肝脏, 2024, 29(2): 211-214.

SUN Gen-lin, WANG Na-na, BAO yang-yi. Incidence and clinical implications of venous thromboembolism in 65 patients with advanced cholangiocarcinoma[J]. Chinese Hepatolgy, 2024, 29(2): 211-214.

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