运用主成分分析及二元多因素logistic回归模型分析恶性实体肿瘤患者血栓前状态发生的影响因素

Study on the risk factors of pre-thrombotic state in patients with malignant solid tumor

目的筛查恶性实体肿瘤患者血栓前状态(PTS)发生的影响因素。方法回顾分析新疆维吾尔自治区人民医院2016年12月-2017年6月入住放疗二科的102例恶性实体肿瘤患者的临床及实验室资料,其中处于PTS的患者67例,其余35例为非PTS的患者。采用主成分分析、单因素分析及多因素logistic回归模型对PTS的影响因素进行分层分析。结果①处于PTS的恶性实体肿瘤患者存在血常规及凝血功能等指标异常(P<0.05);②单因素分析显示PTS在年龄、肿瘤分期、治疗与否、长期卧床、PICC、预防性抗凝以及白细胞计数、血红蛋白、血小板计数、红细胞压积、FIB、D-D等变量中差异均有统计学意义(均P<0.05);③多因素logistic回归模型分析显示PTS在KPS评分、预防性抗凝、长期卧床、PICC等变量因素中差异均有统计学意义(均P<0.05)。结论①PTS的危险因素包括WBC.PLT计数、FIB、D-D等(均P<0.05),而预防性抗凝KPS评分为PTS的保护性因素;②PTS在不同部位恶性实体肿瘤患者中差异无统计学意义(P>0.05);③传统的抗肿瘤治疗既可降低肿瘤负荷,亦可增加PTS发生的风险。④应对长期卧床及置入PICC的恶性实体肿瘤患者给予高度重视。

Objective To screening the possible risk factors of pre-thrombotic state(PTS) in patients with malignant solid tumor. Methods The clinical and laboratory data of 102 cases of malignant solid tumor in our department between December 2016 and June 2017, including 67 patients with PTS and 35 patients without PTS, were retrospectively analyzed. The stratified analyses by principal component analysis, single factor analysis and Multivariate logistic regression analysis was conducted for the risk factors of PTS in patients with malignant solid tumor. Results ①The malignant solid tumor patients in PTS were with abnormal values in laboratory routine blood and blood coagulation test;②The single factor analysis showed that the age, tumor staging, treatment, long-term lie in bed, PICC, prophylactic anticoagulation, and laboratory parameters such as white blood cell count, hemoglobin, platelet count, erythrocyte deposited and FIB, D-D variables were all correlated with PTS(all P<0.05);③The multivariate logistic regression analysis showed that KPS score, tumor staging, prophylactic anticoagulation, long-term lie in bed and PICC were risk factors of PTS, all P<0.05. Conclusion ①The risk factors for PTS include the WBC, PLT count, FIB, D-D, KPS score etc. The prophylactic anticoagulation is the protective factor of PTS. ②PTS varies with the location of malignant solid tumors in different parts of the body, but the difference was not statistically slgnificant(P>0.05). ③Traditional antitumor treatment can reduce the tumor load;however, it also increases the risk of PTS. ④More attentions should be paid for the long-term lie in bed patients and those patients with PICC.