肺癌术后静脉血栓栓塞影响因素的Logistic回归模型构建及临床预测价值  

Construction of Logistic regression model and clinical predictive value of venous thromboembolism influencing factors after lung cancer operation

作　　者：陈国连[1] 张小芳 赵志莹[1] 叶将霞 陈莹莹[1] 石佑玉 黄钰清[1] CHEN Guolian;ZHANG Xiaofang;ZHAO Zhiying;YE Jiangxia;CHEN Yingying;SHI Youyu;HUANG Yuqing(First Affi liated Hospital of Guangxi Medical University,Nanning,530021,China)

机构地区：[1]广西医科大学第一附属医院肿瘤内科,广西壮族自治区南宁市530021

出　　处：《护理实践与研究》2021年第24期3635-3639,共5页Nursing Practice and Research

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题项目(编号:Z20210800)。

摘　　要：目的构建肺癌术后静脉血栓栓塞(VTE)影响因素的Logistic回归模型,并探讨临床预测价值。方法回顾性选取医院2017年1月—2020年10月肺癌患者226例作为研究对象,均接受肺癌根治术治疗,统计术后VTE发生率,根据术后是否发生VTE分为VTE组与非VTE组,收集两组临床资料,构建Logistic回归模型,分析肺癌术后VTE的影响因素,采用似然比χ^(2)、Waldχ^(2)、拟合优度检验评价逻辑(Logistic)回归模型,受试者工作特征(ROC)曲线评价Logistic回归模型预测价值。结果226例均顺利完成肺癌根治术,VTE发生率为12.39%(28/226)。Logistic回归分析得知,高血压、术前接受化疗、慢性阻塞性肺疾病(COPD)、术前D-二聚体(D-D)异常、临床分期Ⅲ~Ⅳ期是肺癌术后VTE的独立危险因素(P<0.05)。Logistic回归模型对肺癌术后VTE预测敏感度为78.57%,特异度为96.46%。结论受多种因素影响,VTE成为肺癌术后常见并发症,Logistic回归模型对VTE的发生具有一定预测能力,但漏诊率较高(21%)。Objective To construct a Logistic regression model of the influencing factors of venous thromboembolism(VTE)after lung cancer operation,and discuss the clinical predictive value.Methods We selected 226 patients with lung cancer in the hospital retrospectively from January 2017 to October 2020 as the study objects.They all received radical resection of lung cancer.The incidence of VTE after surgery was calculated.According to whether VTE occurred after surgery,they were divided into a VTE group and a non-VTE group,we collected two groups of clinical data,construct a Logistic regression model,analyzed the infl uencing factors of VTE after lung cancer,used likelihood ratioχ^(2),Waldχ^(2),goodness of fi t test to evaluate(Logistic)regression model,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of Logistic regression model.Results All 226 patients successfully completed radical resection of lung cancer,and the incidence of VTE was 12.39%(28/226).Logistic regression analysis showed that the hypertension,preoperative chemotherapy,chronic obstructive pulmonary diseases(COPD),preoperative D-dimer(D-D)abnormality,and clinical stage III to IV were the independent risk factors for VTE after lung cancer surgery(P<0.05).The Logistic regression model had 78.57%sensitivity and 96.46%specifi city for predicting VTE after lung cancer surgery.Conclusion Affected by many factors,VTE had become a common complication after lung cancer surgery.Logistic regression model had certain predictive power for the occurrence of VTE,but the missed diagnosis rate was high(21%).

关 键 词：肺癌 静脉血栓栓塞 影响因素 预测价值 独立危险因素 

分 类 号：R473.6[医药卫生—护理学]