Transiently elevated D‐dimer levels post‐concentrated ascites reinfusion therapy cannot be used to predict deep vein thrombosis‐pulmonary embolism
Transiently elevated D‐dimer levels post‐concentrated ascites reinfusion therapy cannot be used to predict deep vein thrombosis‐pulmonary embolism
复制标题
浓缩腹水回输治疗后短暂升高的 D-二聚体水平不能用于预测深静脉血栓形成-肺栓塞
DOI：
10.1111/jog.15162
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发表时间：
2022
影响因子：
1.6
通讯作者：
Osuga Yutaka
中科院分区：
文献类型：
--
作者：
Sone Kenbun;Taguchi Ayumi;Kawata Akira;Eguchi Satoko;Miyamoto Yuichiro;Tanikawa Michihiro;Uchino‐Mori Mayuyo;Iriyama Takayuki;Tsuruga Tetsushi;Osuga Yutaka
目的无细胞浓缩腹水回输治疗（CART）可用于治疗恶性腹水。我们之前经历过尽管CART后D-二聚体显著升高但无DVT-PE的病例。在这项研究中，我们评估了接受CART的患者D-二聚体水平的变化，并研究了D-二聚体水平升高与DVT-PE发生率之间的相关性。方法我们对2018年3月至2021年4月期间接受CART治疗的妇科恶性肿瘤患者进行了观察性回顾性分析。所选患者在CART之前和之后测量其D-二聚体水平。然后检查是否存在临床DVT-PE结果，并在某些情况下使用DVT协议进行对比增强计算机断层扫描。16例手术患者（94.1%）在CART后第1天显示D-二聚体水平显著升高。监测了16例手术患者的D-二聚体水平变化。在所有16例病例中，CART后第2天D-二聚体水平降低。在第1天D-二聚体水平升高的16例手术患者中，只有1例患者（6.2%）出现呼吸衰竭，发生了PE。如果CART后无症状，则本研究中的患者均未发生PE，无需仅通过D-二聚体升高强烈怀疑PE。总之，CART后立即测量D-二聚体对预测DVT-PE的诊断没有帮助。
AimCell‐free and concentrated ascites reinfusion therapy (CART) is useful for treating malignant ascites. We have previously experienced cases with no DVT‐PE despite a marked elevation in D‐dimer post‐CART. In this study, we assessed the changes in the D‐dimer levels in patients who received CART and investigated the association between elevated D‐dimer levels and occurrence of DVT‐PE.MethodsWe performed an observational retrospective analysis of patients with gynecological malignancies treated with CART between March 2018 and April 2021. The selected patients had their D‐dimer levels measured before and post‐CART. The presence or absence of clinical DVT‐PE findings was then examined, and contrast‐enhanced computed tomography was performed using a DVT protocol in some cases.ResultsEleven patients received 17 CART procedures in this study. Patients of 16 procedures (94.1%) showed a significant elevation in D‐dimer levels on day 1 post‐CART. Changes in D‐dimer levels were monitored in these patients of 16 procedures. In all 16 cases, the D‐dimer levels decreased after day 2 post‐CART. Only one patient, who presented with respiratory failure, out of the patients of 16 procedures (6.2%) with elevated D‐dimer levels on day 1 had PE.ConclusionsD‐dimer elevation after CART is likely to be transient and a false‐positive. None of the patients in this study had PE if they were asymptomatic after CART, there is no need to strongly suspect PE only by D‐dimer elevation. In conclusion, D‐dimer measurement immediately post‐CART is not helpful in predicting the diagnosis of DVT‐PE.
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