摘要
目的:构建并验证血小板输注无效的列线图模型。方法:选取2019年1月至12月于温州医科大学附属第二医院育英儿童医院收治的174例血小板输注患者,其中46例血小板输注无效,128例血小板输注有效,收集患者临床资料,包括年龄、性别、多次妊娠、活动性出血、皮肤黏膜出血、脾肿大、发热、ABO血型、输注血小板次数、血小板抗体和血小板计数。采用单因素、多因素Logistic回归分析探讨血小板输注无效的危险因素,构建列线图,并进行验证。结果:多因素Logistic回归分析结果显示:女性(OR=2.43,95%CI=1.08~5.44,P=0.031)、血小板抗体阳性(OR=4.46,95%CI=1.11~17.85,P=0.035)、发热(OR=2.42,95%CI=1.03~5.71,P=0.042)、脾肿大(OR=2.14,95%CI=1.01~5.92,P=0.045)、输注血小板3次以上(OR=4.90,95%CI=2.10~11.42,P=0.002)是血小板输注无效的危险因素,由此建立列线图模型。模型经内部验证(Bootstrap重抽样500次)后,预测血小板输注无效的ROC曲线下面积为0.858。结论:本研究构建的血小板输注无效列线图预测模型准确性良好,有良好的校准度与区分度。
Objective:To construct and validate a nomogram that can be used to predict platelet transfusion refractoriness in patients who received platelet transfusions.Methods:A total of 174 patients who received platelet transfusions were selected from the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University from January 2019 to December 2019.Among 174 patients,46(26.4%)were platelet transfusion refractoriness.Pertinent clinical data were collected including patient age,gender,multiple pregnancies,active bleeding,skin and mucous membrane bleeding,splenomegaly,fever,ABO blood group,number of platelet transfusions,platelet antibody and platelet count.Multivariate logistic regression was used to screen independent factors and to construct the nomogram.Results:Multivariate logistic regression indicated that female(OR=2.43,95%CI=1.08-5.44,P=0.0310),platelet antibody(OR=4.46,95%CI=1.11-17.85,P=0.035),infection(OR=2.42,95%CI=1.03-5.71,P=0.042),splenomegaly(OR=2.14,95%CI=1.01-5.92,P=0.045),infusion times(OR=4.90,95%CI=2.10-11.42,P=0.002)were associated with higher odds of platelet transfusion refractoriness.Afterwards,the above variables were incorporated into the nomogram.Bootstrap test(Bootstrap resampling times=500),used for internal validation,revealed that the AUC was 0.858.Conclusion:The constructed nomogram could potentially predict platelet transfusion refractoriness in patients who received platelet transfusion.
作者
苏高繁
陈静思
郑婷婷
金方思
江明华
SU Gaofan;CHEN Jingsi;ZHENG Tingting;JIN Fangsi;JIANG Minghua(Department of Blood Transfusion,the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325027,China;Department of Clinical Laboratory,the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325027,China)
出处
《温州医科大学学报》
2021年第9期741-745,共5页
Journal of Wenzhou Medical University
关键词
血小板输注无效
危险因素
列线图模型
platelet transfusion refractoriness
risk factors
nomogram model
作者简介
苏高繁,技师,Email:447284204@qq.com。;通信作者:江明华,主任技师,Email:minghua93@126.com。
