非霍奇金淋巴瘤合并肺部感染列线图风险预测模型的建立  

Establishment of nomogram risk prediction model for non-Hodgkin's lymphoma patients complicated with pulmonary infection

作　　者：赵海涛[1] 王春燕[1] 辛杰 王立盼[1] 郭庆伟 ZHAO Hai-tao;WANG Chun-yan;XIN Jie;WANG Li-pan;GUO Qing-wei(Binzhou People's Hospital,Binzhou,Shandong 256600,China;不详)

机构地区：[1]滨州市人民医院血液科,山东滨州256600 [2]山东大学齐鲁儿童医院血液肿瘤科,山东济南250022

出　　处：《中华医院感染学杂志》2020年第21期3258-3262,共5页Chinese Journal of Nosocomiology

基　　金：山东省科技厅基金资助项目(003130103)。

摘　　要：目的研究非霍奇金淋巴瘤(NHL)合并肺部感染的危险因素,并建立列线图风险预测模型。方法选取2015年4月-2019年8月在滨州市人民医院治疗的NHL患者124例,按照是否存在肺部感染分为肺部感染组和无肺部感染组,并采用Logistic回归分析筛选其独立危险因素。结果单因素分析结果显示年龄、是否抽烟、糖尿病、治疗前肺功能(FEV1%)、血白蛋白、是否首次化疗、是否使用糖皮质激素、是否使用免疫调节剂和是否使用抗菌药物均有统计学差异(P<0.05)。多因素Logistic回归分析,结果表明:治疗前肺功能(OR=0.093,95%CI:0.027~0.329)、血白蛋白(OR=0.132,95%CI:0.035~0.492)为肺部感染的保护因素(P<0.05),而年龄(OR=3.511,95%CI:3.012~4.010)、抽烟(OR=4.899,95%CI:4.658~5.130)、首次化疗(OR=3.438,95%CI:1.070~11.044)及使用抗菌药物(OR=11.592,95%CI:3.252~41.318)为肺部感染的危险因素(P<0.05),均与肺部感染高度相关。基于6项NHL患者肺部感染的独立危险因素,建立预测肺部感染的列线图模型。并使用Bootstrap内部验证法进行验证,C-index指数高达0.934(95%CI:0.893~0.975),表明精准度和区分度良好。结论NHL患者的年龄、是否抽烟、治疗前肺功能、血白蛋白、病程、是否首次化疗和是否使用抗菌药物均为NHL患者肺部感染的独立危险因素,可据此提前预防肺部感染风险。OBJECTIVE To explore the risk factors for pulmonary infection in the patients with non-Hodgkin’s lymphoma(NHL)and establish a nomogram risk prediction model.METHODS A total of 124 patients with NHL who were treated in Binzhou People’s Hospital from Apr 2015 to Aug 2019 were enrolled in the study and divided into the pulmonary infection group and the non-pulmonary infection group according to the status of pulmonary infection,and logistic regression analysis was performed to screen out the independent risk factors.RESULTS Univariate analysis showed that there were significant differences in the age,smoking,diabetes mellitus,lung function before treatment(FEV1%),serum albumin,first chemotherapy,use of glucocorticoids,use of immunomodulators and use of antibiotics(P<0.05).The result of multivariate logistic regression analysis indicated that the lung function before treatment(OR=0.093,95%CI:0.027~0.329)and serum albumin(OR=0.132,95%CI:0.035~0.492)were the independent risk factors for the pulmonary infection(P<0.05),while age(OR=3.511,95%CI:3.012~4.010),smoking(OR=4.899,95%CI:4.568~5.130),the first chemotherapy(OR=3.438,95%CI:1.070~11.044)and use of antibiotics(OR=11.592,95%CI:3.252~41.318)were the risk factors for pulmonary infection(P<0.05),all were highly associated with the pulmonary infection.The nomogram model for prediction of pulmonary infection was established based on 6 independent risk factors for pulmonary infection in the NHL patients.The model was verified by using Bootstrap internal validation method,the C-index index was up to 0.934(95%CI:0.893~0.975),indicating that the model had good accuracy and distinguishing degree.CONCLUSION The age,smoking history,lung function before treatment,serum albumin,course of disease,first-time chemotherapy and use of antibiotics are the independent risk factors for the pulmonary infection in the NHL patients,and the pulmonary infection can be preventable if prevention measures are taken in advance.

关 键 词：非霍奇金淋巴瘤 肺部感染 危险因素 风险预测模型 

分 类 号：R733.4[医药卫生—肿瘤]