摘要
目的探讨血栓弹力图参数联合血浆D-二聚体(D-D)、血管性血友病因子(VWF)在多发性骨髓瘤(MM)患者发生静脉血栓栓塞(VTE)中的预测价值。方法选择该院2019年1月至2023年12月收治的272例MM患者作为研究对象,根据治疗后VTE发生情况分为VTE组、非VTE组。采用受试者工作特征(ROC)曲线分析血栓弹力图参数联合血浆D-D、VWF对MM患者发生VTE的预测价值。结果51例患者治疗后发生VTE,纳入VTE组,221例未发生VTE者纳入非VTE组。VTE组凝血反应时间(R值)和凝血形成时间(K值)明显低于非VTE组(P<0.05),凝固角(Angle)明显大于非VTE组(P<0.05)。与非VTE组比较,VTE组D-D和VWF水平均明显升高(P<0.05)。ROC曲线分析结果显示,R值、K值、Angle联合血浆D-D、VWF预测MM患者发生VTE的灵敏度为92.16%,特异度为80.09%,曲线下面积(AUC)为0.861。结论D-D和VWF联合血栓弹力图参数对MM患者发生VTE具有较高预测效能。
Objective To investigate the predictive value of thromboelastography parameters combined with plasma D-dimer(D-D)and von Willebrand factor(VWF)for venous thromboembolism(VTE)in patients with multiple myeloma(MM).Methods A total of 272 MM patients admitted to the hospital from January 2019 to December 2023 were enrolled as research subjects.Based on the occurrence of VTE after treatment,patients were divided into the VTE group and non-VTE group.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of thromboelastography parameters combined with D-D and VWF for the occurrence of VTE in MM patients.Results Among the patients,51 developed VTE after treatment and were assigned to the VTE group,while 221 without VTE were assigned to the non-VTE group.The coagulation reaction time(R value)and coagulation formation time(K value)in the VTE group were significantly lower than those in the non-VTE group(P<0.05),while the clotting angle(Angle)was significantly larger in the VTE group compared with the non-VTE group(P<0.05).Additionally,plasma levels of D-D and VWF were significantly higher in the VTE group than those in the non-VTE group(P<0.05).ROC curve analysis demonstrated that the combination of R value,K value,Angle,plasma D-D and VWF predicted VTE in MM patients with a sensitivity of 92.16%,a specificity of 80.09%,and an AUC of 0.861.Conclusion The combination of D-D,VWF and thromboelastography parameters demonstrates high predictive efficacy for the occurrence of VTE in patients with MM.
作者
吉薇
吴蔚
沈连军
倪军
王红
方悦之
孙幸
施青青
周帮月
王方方
JI Wei;WU Wei;SHEN Lianjun;NI Jun;WANG Hong;FANG Yuezhi;SUN Xing;SHI Qingqing;ZHOU Bangyue;WANG Fangfang(Department of Hematology Laboratory,Northern Jiangsu People′s Hospital,Yangzhou,Jiangsu 225000,China;Department of Hematology,Northern Jiangsu People′s Hospital,Yangzhou,Jiangsu 225000,China)
出处
《检验医学与临床》
2025年第11期1525-1528,1533,共5页
Laboratory Medicine and Clinic
基金
江苏省扬州市科技计划项目(YZ2023085)。
