| 杨磊,冷文华,程晓伟.肺癌病人发生肺栓塞的危险因素和风险列线图模型[J].安徽医药,2021,25(9):1826-1829. |
| 肺癌病人发生肺栓塞的危险因素和风险列线图模型 |
| Risk factors and risk nomogram model of pulmonary embolism in patients with lung cancer |
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| DOI：10.3969/j.issn.1009-6469.2021.09.030 |
| 中文关键词: 肺肿瘤 肺栓塞 危险因素 列线图 |
| 英文关键词: Lung neoplasms Pulmonary embolism Risk factors Nomogram |
| 基金项目: |
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| 摘要点击次数: 1409 |
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| 中文摘要: |
| 目的探讨肺癌病人发生肺栓塞的危险因素，并建立相关列线图预测模型。方法回顾性分析 2018年 8月至 2019年 8月因肺癌于攀枝花市中心医院治疗的 211例病人的临床资料，肺癌合并肺栓塞的病人有 52例，未并发肺栓塞的有 159例，分别设为合并肺栓塞组和单纯肺癌组。对影响肺癌病人发生肺栓塞的相关因素进行分析，并建立相关预测模型。结果单因素分析显示，两组病理类型［腺癌( 51.92%)比( 27.04%)］、 TNM分期［Ⅲ~Ⅳ期( 65.38%)比( 40.25%)］、留置中心静脉导管［( 15.38%)比( 4.40%)］、化疗［( 44.23%)比( 22.01%)］、血红蛋白［≥140 g/L(63.46%)比( 36.48%)］和 D-二聚体［≥0.4 mg/L(53.85%)比( 32.08%)］差异有统计学意义( P<0.05)。 logistic回归分析可知，腺癌( OR=2.835，95%CI:1.355~5.931)、 Ⅲ~Ⅳ期肺癌( OR=2.263，95%CI:1.087~4.710)、留置中心静脉导管( OR=5.065，95%CI:1.535~16.718)、化疗( OR=2.321，95%CI:1.095~ 4.920)、血红蛋白 ≥140 g/L(OR=3.282，95%CI:1.569~6.866)及 D-二聚体 ≥0.4 mg/L(OR=2.772，95%CI:1.341~5.728)是肺癌病人发生肺栓塞的独立危险因素( P<0.05)。据此建立预测肺癌病人发生肺栓塞的列线图模型，模型验证结果显示，预测值同实测值基本一致， C-index为 0.804(95%CI:0.769-0.839)表明模型具有良好的精准度和区分度。结论腺癌、 Ⅲ~Ⅳ期肺癌、留置中心静脉导管、化疗、血红蛋白 ≥140 g/L及 D-二聚体 ≥0mg/L是肺癌病人发生肺栓塞的独立危险因素，本研究构建的列线图模型.4，能够有效预测肺癌病人的肺栓塞发生风险。 |
| 英文摘要: |
| Objective To explore the risk factors of pulmonary embolism in patients with lung cancer and establish a related nomogram prediction model.Methods The clinical data of 211 patients treated in Panzhihua City Central Hospital for lung cancer from August 2018 to August 2019 were retrospectively analyzed. There were 52 patients with lung cancer and pulmonary embolism, and 159 patients without pulmonary embolism. They were set as combined pulmonary embolism group and simple lung cancer group. The relatedfactors that affect the occurrence of pulmonary embolism in patients with lung cancer were analyzed, and related predictive modelswere established.Results Univariate analysis showed that the pathological types of the two groups [adenocarcinoma (51.92%) vs. (27.04%)], TNM staging [Stage Ⅲ-Ⅳ (65.38%) vs. (40.25%)], indwelling central venous catheter [(15.38%) vs. (4.40%)], chemotherapy [(44.23%) vs. (22.01%)], hemoglobin [≥140g/L (63.46%) vs. (36.48%)] and D-dimer [≥0.4 mg/L( 53.85%) vs. (32.08%)] were significantly different (P<0.05). Logistic regression analysis showed that adenocarcinoma (OR=2.835, 95%CI: 1.355-5.931), stage Ⅲ-Ⅳ lung cancer (OR=2.263, 95%CI: 1.087-4.710), Indwelling central venous catheter (OR=5.065, 95%CI: 1.535-16.718), chemotherapy (OR= 2.321, 95%CI: 1.095-4.920), hemoglobin≥140g/L (OR=3.282, 95%CI: 1.569-6.866) and D-dimer≥0.4 mg/L (OR=2.772, 95%CI: 1.3415.728) were independent risk factors for PTE in lung cancer patients (P<0.05). Based on this, a nomogram model for predicting pulmonary embolism in lung cancer patients was established. The verification of the model showed that the predicted value was basically thesame as the measured value, with a C-index of 0.804 (95%CI: 0.769-0.839), indicating that the model had good accuracy and discrimination.Conclusions Adenocarcinoma, stage Ⅲ-Ⅳlung cancer, indwelling central venous catheter, chemotherapy, hemoglobin≥140 g/ L and D-dimer≥0.4 mg/L are independent risk factors for pulmonary embolism in patients with lung cancer. The nomogram model constructed in this paper can effectively predict the risk of pulmonary embolism in patients with lung cancer. |
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