Caprini血栓风险评估模型预测肺癌患者深静脉血栓形成风险的有效性研究

Effectiveness of Caprini thrombosis risk assessment model for predicting the risk of deep vein thrombosis in patients with lung cancer

目的探讨使用Caprini血栓风险评估模型预测肺癌患者深静脉血栓形成发生风险的有效性。方法采用病例对照研究,收集承德市中心医院2014年1月至2018年12月肺癌患者中被确诊为静脉血栓栓塞症(venous thromboembolism,VTE)的100例患者作为病例组(血栓组),并选择同时期入院的非VTE肺癌患者200例作为对照组。依据Caprini血栓风险评估量表对两组患者分别进行评分和危险度分级,比较两组患者的一般临床资料、评分情况及危险度分级的构成,采用Logistic回归模型分析Caprini风险评估量表中的危险因素以及VTE危险度分级与肺癌患者VTE发病风险的关系。结果血栓组患者Caprini风险评分明显高于对照组,差异有统计学意义(P<0.001);血栓组中通过Caprini风险评分量表被评定为极高危和高危的患者比例达98.0%,明显高于对照组,差异有统计学意义(P<0.001);严重的肺部疾病,含肺炎(1个月内)、卧床的内科患者、下肢水肿、中心静脉置管、既往恶性肿瘤和深静脉血栓或肺栓塞病史等6个Caprini血栓风险评估量表中的因素是肺癌合并VTE的主要危险因素。D-二聚体、卧床的内科患者、下肢水肿、中心静脉置管、既往恶性肿瘤、深静脉血栓或肺栓塞病史是肺癌合并VTE的独立危险因素。VTE危险度分级为极高危的肺癌患者是VTE发病的高危人群,极高危肺癌患者合并VTE的发病风险是低危患者的36.573倍。结论Caprini血栓风险评估模型能够很好地评估肺癌患者VTE的发病风险。

Objective To investigate the effectiveness of Caprini thrombosis risk assessment model in predicting the risk of deep vein thrombosis in patients with lung cancer.Methods A case-control study was conducted to collect 100 lung cancer patients with venous thromboembolism(VTE)in Chengde Central Hospital from January 2014 to December2018 as the case group(Thromboembolism group)and 200 non-VTE lung cancer patients admitted at the same time as the control group.Scores and risk grades were determined according to the Caprini thrombosis risk assessment scale.The general clinical data,scores and risk grades were compared between the two groups.Logistic regression model was used to analyze the scores,risk factors in the Caprini risk assessment scale and the relationship between VTE risk rating and the risk of VTE in patients with lung cancer.Results The Caprini risk score was significantly higher in the thrombus group than control group(P<0.001).The Caprini risk score scale was assessed as extremely high risk and high risk in 98.0%of patients within the thrombus group,which was significantly higher than that in the control group(P<0.001).Among the Caprini thrombosis risk assessment scale,severe lungs diseases including pneumonia(within1 month),bedridden medical patients,lower extremity edema,central venous catheterization,previous malignant tumors,and history of deep vein thrombosis or pulmonary embolism were the six main risk factors for VTE in lung cancer patients.D-dimer,bedridden medical patients,lower extremity edema,history of central venous catheterization,previous malignancy,deep vein thrombosis or pulmonary embolism were the independent risk factors.The lung cancer patients,who were classified as extremely high risk based on VTE grading,were at high risk for VTE.These patients had 36.573 times higher risk for VTE than low-risk patients.Conclusion The Caprini thrombosis risk assessment model is a good predictor of the risk of VTE in patients with lung cancer.