宫颈癌患者术后下肢深静脉血栓形成影响因素的分析及预测  

Analysis and Prediction of Influencing Factors of Lower Extremity Deep Vein Thrombosis in Patients with Cervical Cancer

作　　者：镇澜[1] 陈玲思[1] 潘吴媛 衣欢 陈宏[2] 曾邦伟[3] 李红[4] ZHEN Lan;CHEN Lingsi;PAN Wuyuan;YI Huan;CHEN Hong;ZENG Bangwei;LI Hong(Department of Obstetrics and Gynecology,Fujian Maternity and Child Health Hospital(Affiliated Hospital of Fujian Medical University),Fuzhou,Fujian Province,350001 China;Department of Neurology,Fujian Medical University Provincial School of Clinical Medicine(Fujian Provincial Hospital),Fuzhou,Fujian Province,350001 China;Department of Nosocomial Infection Management,Union Hospital,Fujian Medical University,Fuzhou,Fujian Province,350001 China;School of Mathematics and Statistics,Fuzhou University,Fuzhou,Fujian Province,350001 China)

机构地区：[1]福建省妇幼保健院(福建医科大学附属医院)妇产科,福建福州350001 [2]福建医科大学省立临床医学院(福建省立医院)神经内科,福建福州350001 [3]福建医科大学附属协和医院医院感染管理科,福建福州350001 [4]福州大学数学与统计学院,福建福州350001

出　　处：《中外医疗》2021年第24期75-79,共5页China & Foreign Medical Treatment

摘　　要：目的研究影响宫颈癌患者术后下肢深静脉形成的相关因素,以此因素建立风险概率预测模型,以协助判断宫颈癌患者术后发生下肢深静脉血栓形成的风险,为临床实践提供参考。方法回顾性分析2012年5月—2020年12月收治于福建省妇幼保健院的203例宫颈癌病例的临床病理资料,用Logistic回归法筛选出影响下肢深静脉血栓形成相关因素,建立Logistic风险概率预测模型,并算出该模型ROC曲线下面积。结果经过单因素分析显示,年龄、总胆固醇、血浆D-二聚体、血浆纤维蛋白原、病理类型、抗凝为影响宫颈癌患者术后下肢深静脉血栓形成的因素,差异有统计学意义(t=-4.420、-2.020;Z=3.405、2.621;χ^(2)=28.769、7.836,P<0.05);经过Logistic回归分析,结果显示,>55岁,D-二聚体>2 mg/L促进宫颈癌患者术后下肢深静脉血栓形成(OR=4.746、4.407,P<0.01),而使用抗凝剂则抑制宫颈癌患者术后下肢深静脉血栓形成(OR=0.274,P<0.01),由前述3个因素构建的风险预测模型的ROC曲线下面积为0.772(P<0.01),表明该模型预测能力良。结论对于宫颈癌患者术后,年龄、血浆D-二聚体水平、抗凝是用于构建预测下肢深静脉血栓形成风险概率预测模型的相对最优因素,由此构建的风险概率预测模型具有良好的拟合优度和实用性,可为临床实践提供参考。Objective To study the related factors that affect the formation of deep veins of the lower extremities in patients with cervical cancer,and to establish a risk probability prediction model based on these factors to assist in judging the risk of deep vein thrombosis of the lower extremities in patients with cervical cancer and provide reference for clinical practice.Methods The clinical pathological data of 203 cases of cervical cancer admitted to Fujian Provincial Maternity and Child Health Hospital from May 2012 to December 2020 were retrospectively analyzed.Logistic regression method was used to screen out the related factors affecting deep vein thrombosis of lower extremities,and the logistic risk probability prediction was established,and calculate the area under the ROC curve of the model.Results The univariate analysis showed that age,total cholesterol,plasma D-dimer,plasma fibrinogen,pathological type,anticoagulation were factors that affect deep vein thrombosis of the lower extremities in patients with cervical cancer,and the difference wer statistically significant(t=-4.420,-2.020;Z=3.405,2.621;χ^(2)=28.769,7.836,P<0.05);after logistic regression analysis,the results show that it is greater than at 55 years old,D-dimer greater than 2mg/L promotes deep venous thrombosis in patients with cervical cancer after surgery(OR=4.746,4.407,P<0.01),while the use of anticoagulants inhibits cervical cancer In patients with postoperative deep vein thrombosis of the lower extremities(OR=0.274,P<0.01),the area under the ROC curve of the risk prediction model constructed by the aforementioned three factors was 0.772(P<0.01),indicating that the model had a good predictive ability.Conclusion For patients with cervical cancer after surgery,age,plasma D-dimer level,and anticoagulation are the relatively optimal factors for constructing a predictive model for predicting the risk of deep vein thrombosis of the lower extremities,and the risk probability predicting model constructed therefrom has goodness of fit and practicali

关 键 词：宫颈癌 下肢深静脉血栓形成 LOGISTIC回归 ROC曲线 高危因素 保护因素 

分 类 号：R5[医药卫生—内科学]