血液肿瘤患者PICC导管相关性血栓形成的危险因素分析

Estimation of risk factors for PICC catheter related thrombosis in patients with hematologic malignancies

目的:探讨血液肿瘤患者PICC导管相关性血栓形成的危险因素。方法:按照性别、年龄(±2岁)、疾病类型1∶2的配对方法,选择确诊PICC导管相关性血栓的51例血液肿瘤患者作为病例组,未发生PICC导管相关性血栓的102例血液肿瘤患者作为对照组,进行回顾性对照研究。2组指标单因素分析采用分层COX回归分析,多因素分析采用条件Logistic回归分析。结果:51例血液肿瘤患者PICC导管相关性血栓发生的中位时间为22(8~60)天。单因素分析显示,2组超敏C-反应蛋白(P=0.004)、D-二聚体(P=0.043)、输注血制品(P=0.013)、化疗(P=0.014)、注射促红细胞生成素(P=0.000)差异有统计学意义。条件Logistic回归分析显示,2组超敏C-反应蛋白(OR=0.241,95%CI0.085~0.687,P=0.008)、化疗(OR=0.203,95%CI 0.067~0.611,P=0.005)、注射促红细胞生成素(OR=0.218,95%CI0.077~0.616,P=0.004)差异有统计学意义。结论:超敏C-反应蛋白高、化疗、注射促红细胞生成素是血液肿瘤患者PICC导管相关性血栓形成的独立危险因素。

Objective：To investigate the; risk factors of PICC catheter related thrombosis（PICC-CRT）in patients with hematologic malignancies.Method：A 1∶2 matched retrospective case-contrd study paired by gender,age（±2 years）and disease was conducted to compare the data from 51 hematological tumor patients who underwear PICC-CRT and 102 hematological tumor patients without PICC-CRT.Hierarchical COX regression analysis was performed for single factor analysis,and conditional Logistic regression analysis was performed for multivariate analysis.Result：The median time to PICC-CRT was 22（8 to 60）days.Single factor analysis showed that hsCRP（P=0.004）,D-dimer（P=0.043）,blood transfusion（P=0.013）,chemotherapy（P=0.014）and EPO injection（P=0.000）between 2 groups had significant difference.Conditional Logistic regression analysis showed that hs-CRP（OR=0.241,95%CI0.085-0.687,P=0.008）,chemotherapy（OR=0.203,95%CI0.067-0.611,P=0.005）,EPO injection（OR=0.218,95%CI 0.077-0.616,P=0.004）between 2 groups had significant difference.Conclusion：Hs-CRP,chemotherapy and EPO injection are independent risk factors for PICC-CRT in patients with hematological malignancies.