弥漫大B细胞淋巴瘤化疗患者继发心力衰竭风险预测列线图模型的建立  

Establishment of a nomogram model for individualized prediction of secondary heart failure risk in patients with diffuse large B-cell lymphoma undergoing chemotherapy

作　　者：王娜[1] 张飞彦[1] WANG Na;ZHANG Feiyan(Department of Hematology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院江苏省人民医院血液科,江苏南京210029

出　　处：《皖南医学院学报》2025年第1期98-102,共5页Journal of Wannan Medical College

基　　金：江苏省干部保健科研课题(BJ20017)。

摘　　要：目的:构建个体化预测弥漫大B细胞淋巴瘤化疗患者继发心力衰竭风险的列线图模型。方法:选取2019年7月~2022年7月于江苏省人民医院化疗的弥漫大B细胞淋巴瘤患者作为研究对象,收集其临床资料,统计患者化疗期间的心力衰竭发生情况,采用单因素和多因素Logistic回归分析筛选相关影响因素,并建立列线图模型。结果:379例弥漫大B细胞淋巴瘤患者中有41例在化疗期间发生心力衰竭,发生率10.8%。化疗总周期≥5期、低血红蛋白水平和BNP≥100 pg/mL是弥漫大B细胞淋巴瘤化疗患者继发心力衰竭的危险因素(P<0.05),使用多柔比星脂质体和右丙亚胺是其保护因素(P<0.05)。模型验证结果显示,C-index为0.870(95%CI:0.845~0.895),校准曲线趋近于理想曲线,AUC为0.876(95%CI:0.842~0.901)。结论:弥漫大B细胞淋巴瘤化疗患者继发心力衰竭的危险因素较多,本研究构建的列线图模型具有良好的预测能力,有助于优化护理工作。Objective:To establish a nomogram model for tailored prediction of secondary heart failure risk in patients with diffuse large B-cell lymphoma(DLBCL)undergoing chemotherapy.Methods:DLBCL patients undergoing chemotherapy in our hospital were included between July 2019 and July 2022.The clinical data were collected,and the occurrence of heart failure during chemotherapy was analyzed.Both univariate and multivariate logistic regression analyses were used to screen relevant influencing factors,and a nomogram model was then established.Results:In the 379 DLBCL patients,41(10.8%)developed heart failure during chemotherapy.Total chemotherapy period≥5,low hemoglobin level and BNP≥100 pg/mL were independent risk factors for secondary heart failure in DLBCL patients undergoing chemotherapy(P<0.05).The use of doxorubicin liposomes and dexrazoxane were protective factors(P<0.05).The model validation results showed that the C-index was 0.870(95%CI:0.845-0.895),the calibration curve was close to the ideal curve,and the AUC of the ROC curve was 0.876(95%CI:0.842-0.901).Conclusion:There are many risk factors for secondary heart failure in patients with diffuse large B-cell lymphoma undergoing chemotherapy.The established nomogram model has good predictive ability,which is helpful to optimize nursing work.

关 键 词：弥漫大B细胞淋巴瘤 化疗 心力衰竭 列线图 

分 类 号：R473.73[医药卫生—护理学]