[1]李鸿君,洪 磊,刘 丹,等.下肢动脉硬化闭塞症介入治疗后下肢深静脉血栓形成列线图模型建立及验证[J].介入放射学杂志,2024,33(07):780-784.
 LI Hongjun,HONG Lei,LIU Dan,et al.Establishment and verification of a nomogram model used for predicting lower extremity deep venous thrombosis after interventional treatment of lower extremity arteriosclerosis obliterans[J].journal interventional radiology,2024,33(07):780-784.
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下肢动脉硬化闭塞症介入治疗后下肢深静脉血栓形成列线图模型建立及验证()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年07
页码:
780-784
栏目:
临床研究
出版日期:
2024-07-23

文章信息/Info

Title:
Establishment and verification of a nomogram model used for predicting lower extremity deep venous thrombosis after interventional treatment of lower extremity arteriosclerosis obliterans
作者:
李鸿君 洪 磊 刘 丹 万立松 丁 锐
Author(s):
LI Hongjun HONG Lei LIU Dan WAN Lisong DING Rui.
Department of Vascular Surgery, Binhu Campus of Hefei First People’s Hospital, Anhui Province 230061, China
关键词:
【关键词】 下肢动脉硬化闭塞症 介入治疗 下肢深静脉血栓 列线图模型 决策曲线
文献标志码:
A
摘要:
【摘要】 目的 建立下肢动脉硬化闭塞症(LEASO)介入治疗后下肢深静脉血栓(DVT)形成列线图模型,并对模型进行外部验证。方法 以2020年1月至2022年12月日本血管外科学会建立的肢端缺血患者数据库(JCLIMB)中接受腔内治疗的LEASO患者434例为建模组,以本院2020年1月至2023年5月接受介入治疗的LEASO患者60例为验证组。通过电子病历系统获取患者性别、年龄、合并糖尿病、合并高血压、合并冠心病、体质量指数(BMI)、Fontaine分期、D-二聚体、凝血酶原时间(PT)、活化部分凝血活酶(APTT)、血小板淋巴细胞比值(PLR)和中性粒细胞淋巴细胞比值(NLR)等临床资料。使用R软件建立列线图模型,并以校准曲线、决策曲线(DCA)和受试者工作特征曲线评价预测模型。结果 建模组发生DVT与未发生DVT患者BMI、Fontaine分期、D-二聚体、PLR和NLR比较差异有统计学意义(P<0.05);多因素logistics回归分析结果发现,BMI、Fontaine分期、D-二聚体、PLR和NLR是LEASO患者并发DVT的独立影响因素(P<0.05)。基于logistics回归分析结果建立列线图模型,经校准曲线分析显示模型预测值与实际值基本一致,表明该列线图模型有较好的准确度。以净收益为纵坐标,以阈值为横坐标,None线代表所有LEASO患者均不会发生DVT,Nomogram model表示DVT实际发生曲线,阈值范围0.09~1.00,表明以该模型进行决策有较好的临床收益,具备临床实用性。ROC分析结果显示,本研究建立的列线图模型预测建模组、验证组LEASO患者发生DVT曲线下面积分别为0.912和0.834,灵敏度分别为96.50和和99.20,特异度分别为76.60和66.70。结论 以BMI、Fontaine分期、D-二聚体、PLR和NLR建立的LEASO患者并发DVT预测模型对于DVT发生有较好的预测价值,适宜在临床中推广应用。

参考文献/References:

[1] 逯 莹,甘红艳,袁艳艳,等. 下肢动脉硬化闭塞症介入术后患者运动康复依从性影响因素研究现状[J]. 介入放射学杂志,2023, 32:288-292.
[2] 葛静萍,刘国鹏,尹媛媛,等. 基于踝臂指数构建下肢动脉硬化闭塞症介入围术期护理方案的探讨[J]. 介入放射学杂志, 2022, 31:1007-1010.
[3] Zhou B,She J,Wang Y,et al. Venous thrombosis and arteriosclerosis obliterans of lower extremities in a very severe patient with 2019 novel coronavirus disease: a case report[J]. J Thromb Thrombolysis, 2020, 50: 229-232.
[4] Gu J,Xu K,Teng G. Consensus among Chinese experts on standard interventional therapy for deep venous thrombosis of lower extremity(second edition)[J]. J Interv Med, 2018, 1: 125-136.
[5] Sutedjo J, Li Y, Gu J. Manual aspiration thrombectomy for acute and subacute inferior vena cava thrombosis and lower extremity deep venous thrombosis[J]. J Interv Med, 2018, 1: 197-204.
[6] Mulder FI,Candeloro M,Kamphuisen PW,et al. The khorana score for prediction of venous thromboembolism in cancer patients: a systematic review and meta-analysis[J]. Haematologica, 2019, 104: 1277-1287.
[7] Covut F,Ahmed R,Chawla S,et al. Validation of the IMPEDE VTE score for prediction of venous thromboembolism in multiple myeloma: a retrospective cohort study[J]. Br J Haematol, 2021, 193: 1213-1219.
[8] Hayssen H, Cires-Drouet R, Englum B, et al. Systematic review of venous thromboembolism risk categories derived from Caprini score[J]. J Vasc Surg Venous Lymphat Disord, 2022, 10:1401.e7-1409.e7.
[9] Golemi I,Salazar Adum JP,Tafur A,et al. Venous thromboembolism prophylaxis using the Caprini score[J]. Dis Mon, 2019, 65: 249-298.
[10] Liu H,Yuan H,Wang Y,et al. Prediction of venous thromboembolism with machine learning techniques in young-middle-aged inpatients[J]. Sci Rep, 2021, 11: 12868.
[11] Deng RX,Zhu XL,Zhang AB,et al. Machine learning algorithm as a prognostic tool for venous thromboembolism in allogeneic transplant patients[J]. Transplant Cell Ther, 2023, 29: 57.e1-57.e10.
[12] 中华医学会外科学分会血管外科学组. 下肢动脉硬化闭塞症诊治指南[J]. 中华普通外科学文献(电子版), 2016, 10:1-18.
[13] 刘金雨,朱小可,李玮玮,等. 下肢动脉硬化闭塞症患者下肢动脉转流术后小腿肌间静脉血栓形成危险因素及预测模型构建[J]. 中国现代普通外科进展, 2022, 25:721-725.
[14] 沈瑞东,杨澄宇,骆曦图,等. IL-6高表达对下肢动脉硬化闭塞症患者继发下肢深静脉血栓形成发生率的影响[J]. 中华血管外科杂志, 2023, 8:48-52.
[15] 尹晓霞,孙有伟,王玉涛,等. 下肢动脉硬化闭塞症腔内治疗术后发生静脉血栓栓塞症的危险因素[J]. 中国现代普通外科进展, 2022, 25:352-355, 361.
[16] Khoury H, Lyons R, Sanaiha Y, et al. Deep venous thrombosis and pulmonary embolism in cardiac surgical patients[J]. Ann Thorac Surg, 2020, 109: 1804-1810.
[17] Olinger CR,Gardocki RJ. Deep venous thrombosis and pulmonary embolism after minimally invasive transforaminal lumbar interbody fusion: report of 2 cases in 315 procedures[J]. Orthop Clin North Am, 2020, 51: 423-425.
[18] Audu CO, Gordon AE, Obi AT, et al. Inflammatory biomarkers in deep venous thrombosis organization, resolution, and post-thrombotic syndrome[J]. J Vasc Surg Venous Lymphat Disord, 2020, 8: 299-305.
[19] Peng L,Bao Q,Hong X,et al. High level of neutrophil to lymphocyte ratio increases the risk of deep venous thrombosis in intensive care unit patients after oral cancer surgery: a retrospective study[J]. Ann Transl Med, 2022, 10: 763.
[20] Melinte RM,Arbanasi EM,Blesneac A,et al. Inflammatory biomarkers as prognostic factors of acute deep vein thrombosis following the total knee arthroplasty[J]. Medicina(Kaunas), 2022, 58: 1502.

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备注/Memo

备注/Memo:
(收稿日期:2023-07-20)
(本文编辑:新 宇)
更新日期/Last Update: 2024-07-23