多中心肿瘤患者血小板输注效果预测模型的建立及应用效果评价  

Establishment and evaluation of predictive models of platelet transfusion effect in multi⁃center tumor patients

作　　者：赵刚[1] 郭凡[2] 李清[1] 谢怡华 李君[3] ZHAO Gang;GUO Fan;LI Qing;XIE Yihua;LI Jun(Department of Blood Transfusion,Affiliated Hospital of Tradi-tional Chinese Medicine of Xinjiang Medical University,Urumqi 830000,China;Laboratory Department,the Affiliated Cancer Hospital of Xinjiang Medical University;Department of Blood Transfusion,Kailuan General Hospital)

机构地区：[1]新疆医科大学附属中医医院输血科,新疆乌鲁木齐830000 [2]新疆医科大学附属肿瘤医院检验科 [3]开滦总医院输血科

出　　处：《中国输血杂志》2023年第6期471-474,共4页Chinese Journal of Blood Transfusion

基　　金：新疆维吾尔自治区“青年科技人才-乡村振兴”项目(XJWJ-XCZX202210);新疆医科大学附属中医医院院级课题项目(ZYY2020ZD06);河北省2023年度医学科学研究课题计划(20231864)。

摘　　要：目的研究肿瘤患者血小板输血效果预测模型,并评价其应用效果。方法回顾性调查2022年8月—2023年1月在新疆医科大学附属中医医院、新疆医科大学附属肿瘤医院以及开滦总医院接受输血小板治疗的肿瘤患者944名,其中男性533例,女性411例。利用多因素Logistic回归分析建立血小板输注疗效回归分析模型,应用Medcalc15.8软件绘制受试者工作曲线评价回归分析的应用效果,利用162例女性临床病例和172例男性临床病例验证模型实际应用效果。结果3个研究中心肿瘤患者血小板输注无效发生率为28.9%(273/944);男性输注无效率为33.2%(177/533)显著高于女性输注无效率为23.4%(96/411)(P<0.05)。血小板输血效果预测模型:Y1(女性)=-8.546+(0.581×妊娠次数)+(0.964×住院输血袋数)+既往血小板输注袋数(5~9袋:1.259,≥20袋:1.959)+临床诊断(淋巴瘤:2.562,白血病:3.214);Y2(男性)=-7.600+(1.150×住院输血袋数)+既往血小板输注袋数(10~19袋:1.015,≥20袋:0.979)+临床诊断(淋巴瘤:1.81,白血病:3.208,肝癌:1.714)。应用效果评价:女性、男性预测模型AUC(曲线下面积)、截点、对应的敏感度和特异度分别为:0.868、-0.354、68.75%、89.84%和0.854、-0.942、81.36%、77.53%。实际应用结果显示:女性、男性预测模型的灵敏度、特异度、准确度分别为89.47%、92.74%、91.98%和83.72%、91.47%、89.53%。结论肿瘤患者血小板输注无效率较高,预测模型对肿瘤患者血小板输注无效有较好的预测效果,可为肿瘤患者精准输注血小板提供可靠的依据。Objective To study the platelet transfusion predictive models in tumor patients and evaluate its application effect.Methods A retrospective study was conducted on 944 tumor patients,including 533 males and 411 females who re⁃ceived platelet transfusion in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University,the Affil⁃iated Cancer Hospital of Xinjiang Medical University and Kailuan General Hospital from August 2022 to January 2023.Multi⁃variate Logistic regression analysis was used to establish the platelet transfusion predictive models,and Medcalc15.8 software was used to draw the receiver operating curve(ROC)to evaluate the application effect of the prediction model.The actual application effect of models was verified through 162 female clinical cases and 172 male clinical cases.Results The inci⁃dence of platelet transfusion refractoriness in tumor patients was 28.9%(273/944),with 33.2%(177/533)in males,sig⁃nificantly higher than that in females[23.4%(96/411)](P<0.05).Platelet transfusion predictive models:Y1(female)=-8.546+(0.581×number of pregnancies)+(0.964×number of inpatient transfusion bags)+number of previous platelet transfusion bags(5-9 bags:1.259,≥20 bags:1.959)+clinical diagnosis(lymphoma:2.562,leukemia:3.214);Y2(male)=-7.600+(1.150×inpatient transfusion bags)+previous platelet transfusion bags(10-19 bags:1.015,≥20 bags:0.979)+clinical diagnosis(lymphoma:1.81,leukemia:3.208,liver cancer:1.714).Application effect evaluation:The AUC(area under the curve),cut⁃off point,corresponding sensitivity and specificity of female and male platelet transfusion effect prediction models were 0.868,-0.354,68.75%,89.84%and 0.854,-0.942,81.36%,77.53%,respectively.Actu⁃al application results showed that the sensitivity,specificity,and accuracy of female and male model were 89.47%,92.74%,91.98%and 83.72%,91.47%,89.53%,respectively.Conclu⁃sion There is high incidence of platelet transfusion refractori⁃ness in tumor patients,and the predictive model has good pre⁃d

关 键 词：血小板输注无效 多因素LOGISTIC回归分析 预测模型 应用效果 

分 类 号：R331.143[医药卫生—人体生理学] R730.5[医药卫生—基础医学]