基于倾向性评分匹配法探讨急性早幼粒细胞白血病并发DIC的因素  

Factors exploration of acute promyelocytic leukemia complicated with DIC based on propensity score matching method

作　　者：陈珍珠[1] 刘涛[1] 郭贺贺 仁文文 王凯[1] 庞迎旭 Chen Zhenzhu;Liu Tao;Guo Hehe;Ren Wenwen;Wang Kai;Pang Yingxu(Department of Hematology,Zhoukou Central Hospital,Zhoukou,Henan 466000,China)

机构地区：[1]周口市中心医院血液科,河南周口466000

出　　处：《齐齐哈尔医学院学报》2023年第17期1632-1636,共5页Journal of Qiqihar Medical University

摘　　要：目的 基于倾向性评分匹配法探讨急性早幼粒细胞白血病并发弥漫性血管内凝血(DIC)的因素。方法 回顾性分析2017年2月-2023年2月本院收治的254例急性早幼粒细胞白血病患者的临床资料,根据是否并发DIC将其分为并发组(n=114)和未并发组(n=140)两组。运用倾向性评分匹配法按照1︰1比例控制两组患者的性别、年龄、体质量指数(BMI)、糖尿病、冠心病、高血压一般资料,比较匹配前后两组一般资料,并通过单因素和多因素Logistic回归分析法分析匹配后急性早幼粒细胞白血病并发DIC的影响因素。结果 经倾向性评分匹配后,共成功匹配74对病例。匹配前,并发组与未并发组性别、年龄、冠心病、高血压比较,差异无统计学意义(P>0.05),而体质量指数(BMI)、糖尿病比较,差异具有统计学意义(P<0.05);匹配后,并发组与未并发组性别、年龄、BMI、糖尿病、冠心病、高血压比较,差异无统计学意义(P>0.05)。单因素分析结果显示,匹配后两组患者发病至入院时间、诱导缓解治疗方案、血红蛋白(Hb)水平、肌酐(SCr)水平、尿酸(UA)水平、乳酸脱氢酶(LDH)水平、外周血原始细胞比例比较,差异无统计学意义(P>0.05);并发组合并感染、合并出血占比和白细胞(WBC)计数、血小板(PLT)计数、纤维蛋白原(Fib)水平、D-二聚体(D-D)水平、骨髓原早幼粒细胞比例均高于未并发组(P<0.05);多因素Logistic回归分析结果显示,合并感染、合并出血以及WBC计数、PLT计数、Fib水平、D-D水平和骨髓原早幼粒细胞比例升高均是急性早幼粒细胞白血病并发DIC的危险因素(P<0.05)。结论 合并感染、合并出血以及WBC计数、PLT计数、Fib水平、D-D水平和骨髓原早幼粒细胞比例升高均是急性早幼粒细胞白血病并发DIC的危险因素,临床可采取针对性的防治措施,改善患者预后。Objective To explore the factors of acute promyelocytic leukemia complicated with disseminated intravascular coagulation(DIC)based on propensity score matching method.Methods The clinical data of 254 patients with acute promyelocytic leukemia admitted to our hospital from February 2017 to February 2023 were retrospectively analyzed.They were divided into concurrent group(n=114)and non-concurrent group(n=140)according to whether they were complicated with DIC.The general data including gender,age,body mass index(BMI),diabetes,coronary heart disease,hypertension of the two groups were controlled by the propensity score matching method according to 1:1 ratio,and the general data of the two groups before and after matching were compared.The influencing factors of DIC in matched acute promyelocytic leukemia were analyzed by univariate factor and multivariate Logistic regression analysis.Results A total of 74 pairs of cases were successfully matched after the propensity score matching.Before matching,there were no significant difference in gender,age,coronary heart disease and hypertension between the concurrent group and the non concurrent group(P>0.05),but there were significant difference in BMI and diabetes(P<0.05).After matching,there were no significant difference in sex,age,BMI,diabetes,coronary heart disease and hypertension between the concurrent group and the non-concurrent group(P>0.05).The results of univariate analysis showed that after matching,there were no statistically significant difference between the two groups in terms of the time from onset to admission,induced remission treatment regimen,the levels of hemoglobin(Hb),serum creatinine(SCR),uric acid(UA)and lactate dehydrogenase(LDH),and the proportion of peripheral blood primitive cells(P>0.05).The combined infection and combined bleeding,white blood cell(WBC)count,platelet(PLT)count,the levels of fibrinogen(FIB)and D-dimer(D-D),and the proportion of bone marrow promyelocytes in the concurrent group were higher than those in the non-concurrent grou

关 键 词：倾向性评分匹配法 急性早幼粒细胞白血病 弥漫性血管内凝血 影响因素 

分 类 号：R733.71[医药卫生—肿瘤]