肿瘤患者中心静脉导管相关性血栓形成与炎症指标的关系

Relationship between central venous catheter-related thrombosis and inflammatory indexes in tumor patients

目的探讨炎症指标与肿瘤患者中心静脉导管相关性血栓形成(CRT)的相关性,为临床预测及防治CRT的形成提供参考依据。方法回顾性分析延边大学附属医院2018年4—8月收治的696例首次接受中心静脉导管置入的患者临床资料,探讨炎症指标与肿瘤患者CRT发生率的相关性。根据有无CRT将纳入的患者分为两个组,分别是CRT组和N-CRT组,分别为54和642例。单因素分析影响CRT发生的相关的危险因素,采用logistic回归分析差异有统计学意义的因素,筛选与CRT相关的独立危险因素。结果在696例肿瘤置管患者中,54例患者经彩色多普勒超声检查证实有CRT,发生率为7.76%。单因素分析结果表明,民族、糖尿病病史、吸烟史、高血压病史、纤维蛋白原浓度、中性粒细胞计数、中性粒细胞与淋巴细胞的比值(NLR)及血小板与淋巴细胞的比值(PLR)与CRT的发生有相关性(P<0.05);两组年龄、性别、远处转移、肿瘤分类和置管类型相比较,差异无统计学意义(P>0.05)。多因素分析结果显示,民族、糖尿病病史、吸烟史、高血压病史、纤维蛋白原浓度、中性粒细胞计数和NLR与肿瘤患者CRT无相关性(P>0.05);PLR与肿瘤患者CRT存在相关性(P<0.05),是肿瘤置管患者CRT的独立预测因子。结论肿瘤患者CRT的发生与多种因素相关,外周血PLR可以作为独立预测肿瘤患者CRT的危险因子。

Objective To explore the correlation between inflammatory indexes and central venous catheterrelated thrombosis(CRT)in tumor patients,so as to provide re ference for clinical prediction,and prevention and treatment of CRT.Methods The clinical data of 696 patients who received central venous catheter insertion for the first time from April to August 2018 in Yanbian University Hospital were retrospectively analyzed,and the correlation between inflammatory indexes and CRT incidence in tumor patients was explored.According to the presence or absence of CRT,the patients were divided into two groups:CRT group and N-CRT group,with 54 and 642 cases,respectively.Univariate analysis was adopted to explore the correlated risk factors affecting the CRT incidence,and logistic regression analysis was adopted to explore the factors with statistical significance and screen out the independent risk factors correlated to the formation of CRT.Results Among the 696 patients with tumor catheterization,color Doppler ultrasonography confirmed the formation of CRT in 54 patients,and the incidence was 7.76%.The results of univariate analysis showed that compared with the N-CRT group,the nationality,diabetes history,smoking history,hypertension history,fibrinogen concentration,neutrophil count,neutrophils to lym phocytes(NL R)and the ratio of platelets to lym phocytes(P LR)of patients in the CRT group were correlated with the incidence of CRT(P<0.05).There were no statistical differences between the two groups in age,gender,distant metastasis,tumor classification and catheterization type(P>0.05).The results of multivariate analysis showed that nationality,diabetes history,smoking history,hypertension history,fibrinogen concentration,neutrophil count,and NLR were not correlated with CRT formation in patients(P>0.05).There was a correlation between PLR and CRT formation in tumor patients(P<0.05),and PLR was an independent predictor of CRT formation in patients with tumor catheterization(P<0.05).Conclusion The incidence of CRT in tumor patients is correlated to a variety of factors,and PLR in peripheral blood can be used as an independent risk factor to predict CRT formation in tumor patients.