目的 采用Logistic回归分析急性白血病患儿诱导化疗期中心静脉导管(areas under the curve,PICC)相关血栓的影响因素。方法 回顾性选取急性白血病患儿184例,根据诱导化疗期(置管后15 d)导管部位超声检查是否发现血栓分为血栓组(38例)与...目的 采用Logistic回归分析急性白血病患儿诱导化疗期中心静脉导管(areas under the curve,PICC)相关血栓的影响因素。方法 回顾性选取急性白血病患儿184例,根据诱导化疗期(置管后15 d)导管部位超声检查是否发现血栓分为血栓组(38例)与无血栓组(146例)。收集2组临床资料,采用单因素、Logistic回归多因素分析急性白血病患儿诱导化疗期PICC相关血栓的影响因素,并采用受试者工作特征(areas under the curve,ROC)曲线评价Logistic多因素回归模型对急性白血病患儿诱导化疗期PICC相关血栓的预测价值。结果 2组年龄、性别、疾病类型、疾病危险度、置管静脉、置管时白细胞(white blood cell,WBC)、血小板计数(platelet count,PLT)、D二聚体(D dimer,D-D)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、置管后15 d WBC、PLT、PT、APTT水平比较差异无统计学意义(P>0.05);2组置管位置、合并导管相关感染、使用止血药物、置管后15 d D-D水平比较差异有统计学意义(P<0.05)。Logistic回归多因素分析,右侧置管、合并导管相关感染、使用止血药物、置管后15 d D-D水平过高是急性白血病患儿诱导化疗期PICC相关血栓的独立危险因素(P<0.05);ROC曲线分析,Logistic多因素回归模型对急性白血病患儿诱导化疗期PICC相关血栓的预测AUC为0.917,95%CI:0.866~0.954,敏感度为84.21%,特异度为84.44%。结论 急性白血病患儿诱导化疗期PICC相关血栓的独立危险因素较多,构建Logistic多因素回归模型预测价值可靠,有利于降低PICC相关血栓发生风险。展开更多
Objective:The purpose of this study was to assess the curative effect and adverse reaction of preoperative induction chemotherapy with gemcitabine combined with cisplatin for locally advanced non-small cell lung cance...Objective:The purpose of this study was to assess the curative effect and adverse reaction of preoperative induction chemotherapy with gemcitabine combined with cisplatin for locally advanced non-small cell lung cancer(NSCLC).Methods:This prospective randomized controlled trial included 115 patients with locally advanced NSCLC were randomly divided into experimental and control groups and were treated from January 2007 to January 2010.The experimental group of 63 cases was treated with two cycles of induction chemotherapy before operation,radical surgery had been performed about three weeks after completion of chemotherapy,followed by received two cycles of chemotherapy.And the control group(52 cases) was treated at first with radical surgery,then treated with four cycles of chemotherapy.Two groups of the cases received routine thoracic radiotherapy with a total dose of 45 Gy.One cycle of gemcitabine combined with cisplatin regimen included gemcitabine 1000 mg/m2 on day 1 and day 8 and cisplatin 25 mg/m2 on day 1,day 2 and day 3 by intravenous infusion,with 21 days as one cycle.The tumor recurrence was evaluated by chest CT and abdominal B-ultrasound.Efficacy and toxicity results were compared by two groups.Results:All patients were followed up for three months to two years.The surgical stage of the experimental group reduced,two-years disease-free survival and postoperative recovery in the experimental group were better than in the control group,the difference was statistical significant.Toxicity and side effect after chemotherapy were mainly bone marrow suppression and gastrointestinal reactions,other complications included thrombocytopenia,leukopenia,anemia,liver and kidney dysfunction were no significant difference in two groups.Conclusion:Preoperative induction chemotherapy with gemcitabine combined with cisplatin for locally advanced lung cancer can reduce the surgical staging and extend the postoperative disease-free survival.展开更多
文摘目的 采用Logistic回归分析急性白血病患儿诱导化疗期中心静脉导管(areas under the curve,PICC)相关血栓的影响因素。方法 回顾性选取急性白血病患儿184例,根据诱导化疗期(置管后15 d)导管部位超声检查是否发现血栓分为血栓组(38例)与无血栓组(146例)。收集2组临床资料,采用单因素、Logistic回归多因素分析急性白血病患儿诱导化疗期PICC相关血栓的影响因素,并采用受试者工作特征(areas under the curve,ROC)曲线评价Logistic多因素回归模型对急性白血病患儿诱导化疗期PICC相关血栓的预测价值。结果 2组年龄、性别、疾病类型、疾病危险度、置管静脉、置管时白细胞(white blood cell,WBC)、血小板计数(platelet count,PLT)、D二聚体(D dimer,D-D)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、置管后15 d WBC、PLT、PT、APTT水平比较差异无统计学意义(P>0.05);2组置管位置、合并导管相关感染、使用止血药物、置管后15 d D-D水平比较差异有统计学意义(P<0.05)。Logistic回归多因素分析,右侧置管、合并导管相关感染、使用止血药物、置管后15 d D-D水平过高是急性白血病患儿诱导化疗期PICC相关血栓的独立危险因素(P<0.05);ROC曲线分析,Logistic多因素回归模型对急性白血病患儿诱导化疗期PICC相关血栓的预测AUC为0.917,95%CI:0.866~0.954,敏感度为84.21%,特异度为84.44%。结论 急性白血病患儿诱导化疗期PICC相关血栓的独立危险因素较多,构建Logistic多因素回归模型预测价值可靠,有利于降低PICC相关血栓发生风险。
基金Supported by a grant from the Research Foundation of Education Bureau of Hubei Province,China (No. B20112116)
文摘Objective:The purpose of this study was to assess the curative effect and adverse reaction of preoperative induction chemotherapy with gemcitabine combined with cisplatin for locally advanced non-small cell lung cancer(NSCLC).Methods:This prospective randomized controlled trial included 115 patients with locally advanced NSCLC were randomly divided into experimental and control groups and were treated from January 2007 to January 2010.The experimental group of 63 cases was treated with two cycles of induction chemotherapy before operation,radical surgery had been performed about three weeks after completion of chemotherapy,followed by received two cycles of chemotherapy.And the control group(52 cases) was treated at first with radical surgery,then treated with four cycles of chemotherapy.Two groups of the cases received routine thoracic radiotherapy with a total dose of 45 Gy.One cycle of gemcitabine combined with cisplatin regimen included gemcitabine 1000 mg/m2 on day 1 and day 8 and cisplatin 25 mg/m2 on day 1,day 2 and day 3 by intravenous infusion,with 21 days as one cycle.The tumor recurrence was evaluated by chest CT and abdominal B-ultrasound.Efficacy and toxicity results were compared by two groups.Results:All patients were followed up for three months to two years.The surgical stage of the experimental group reduced,two-years disease-free survival and postoperative recovery in the experimental group were better than in the control group,the difference was statistical significant.Toxicity and side effect after chemotherapy were mainly bone marrow suppression and gastrointestinal reactions,other complications included thrombocytopenia,leukopenia,anemia,liver and kidney dysfunction were no significant difference in two groups.Conclusion:Preoperative induction chemotherapy with gemcitabine combined with cisplatin for locally advanced lung cancer can reduce the surgical staging and extend the postoperative disease-free survival.
