心脏粘液瘤瘤体大小形态及纤维蛋白原水平与血管栓塞发生的相关性

Correlation among size and morphology of cardiac myxoma,fibrinogen level and vascular embolism

目的分析心脏粘液瘤(CM)瘤体大小形态及纤维蛋白原(FIB)水平与血管栓塞发生的相关性。方法回顾性分析2010年1月至2020年1月于郑州大学第一附属医院收治的100例CM患者临床资料,根据其有无血管栓塞分为栓塞组(31例)和无栓塞组(69例),对两组患者一般资料进行单因素及Logistics多因素回归分析;绘制受试者工作特征曲线(ROC)分析瘤体大小、形态及血浆FIB水平对CM患者血管栓塞的预测价值。结果根据术前影像学检查结果,分为栓塞组和无栓塞组,两组瘤体大小、形态、FIB比较差异有统计学意义(P<0.05),其余指标比较差异无统计学意义(P>0.05)。多因素logistic回归分析显示:CM瘤体大、形态不规则以及FIB水平高为CM发生血管栓塞的危险因素。ROC曲线显示,瘤体大小、形态、FIB水平及其联合预测CM并发血管栓塞的曲线下面积(AUC)分别为0.749、0.780、0.798、0.854,联合预测AUC明显大于单一预测方法。结论CM瘤体大小、形态及患者血浆纤维蛋白原水平与血管栓塞发生呈正相关关系,且联合用于血管栓塞预测的临床价值显著。

Objective To analyze the correlation among size and morphology of cardiac myxoma(CM),level of fibrinogen(FIB)and vascular embolism.Methods CM patients(n=100)were retrospectively analyzed in the First Affiliated Hospital of Zhengzhou University from Jan.2010 to Jan 2020,and all patients were divided,according to with vascular embolism or without vascular embolism,into embolism group(n=31)and non-embolism group(n=69).The general materials were analyzed by using single-factor and multi-factor Logistics regression analysis.The predictive value of CM size and morphology and FIB level to vascular embolism in CM patients were analyzed through drawing ROC curved.Results According to outcomes of preoperative imaging examination,the differences in CM size and morphology and FIB level had statistical significance(P<0.05),and differenced in other indexes had no statistical significance(P>0.05)between 2 groups.The results of multi-factor Logistic regression analysis showed that large tumor body and irregular morphology of CM and higher FIB level were risk factors of CM occurrence.The results of ROC curve analysis showed that AUC of CM size was 0.749,AUC of CM morphology was 0.780,AUC of FIB level was 0.798,and AUC of combined prediction of CM complicated by vascular embolism was 0.854.AUC was significantly higher by using combined method than that by using single method.Conclusion CM size and morphology and FIB level are positively correlated to vascular embolism occurrence,and clinical value of combined detection is significant to prediction of vascular embolism.