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章俏雷, 叶琇锦, 方炳木, 江锦红, 刘永华, 王晓丽, 江妤, 金伟媚, 曾玉晓. 急性非早幼粒细胞白血病患者早期颅内出血预警评分系统的建立及应用[J]. 肿瘤防治研究, 2020, 47(9): 667-671. DOI: 10.3971/j.issn.1000-8578.2020.19.1640
引用本文: 章俏雷, 叶琇锦, 方炳木, 江锦红, 刘永华, 王晓丽, 江妤, 金伟媚, 曾玉晓. 急性非早幼粒细胞白血病患者早期颅内出血预警评分系统的建立及应用[J]. 肿瘤防治研究, 2020, 47(9): 667-671. DOI: 10.3971/j.issn.1000-8578.2020.19.1640
ZHANG Qiaolei, YE Xiujin, FANG Bingmu, JIANG Jinhong, LIU Yonghua, WANG Xiaoli, JIANG Yu, JIN Weimei, ZENG Yuxiao. Establishment and Application of Warning Scoring System for Early Intracranial Hemorrhage in Acute Non-promyelocytic Leukemia Patients[J]. Cancer Research on Prevention and Treatment, 2020, 47(9): 667-671. DOI: 10.3971/j.issn.1000-8578.2020.19.1640
Citation: ZHANG Qiaolei, YE Xiujin, FANG Bingmu, JIANG Jinhong, LIU Yonghua, WANG Xiaoli, JIANG Yu, JIN Weimei, ZENG Yuxiao. Establishment and Application of Warning Scoring System for Early Intracranial Hemorrhage in Acute Non-promyelocytic Leukemia Patients[J]. Cancer Research on Prevention and Treatment, 2020, 47(9): 667-671. DOI: 10.3971/j.issn.1000-8578.2020.19.1640

急性非早幼粒细胞白血病患者早期颅内出血预警评分系统的建立及应用

Establishment and Application of Warning Scoring System for Early Intracranial Hemorrhage in Acute Non-promyelocytic Leukemia Patients

  • 摘要:
    目的 回顾性分析急性非早幼粒细胞白血病(ANPL)早期颅内出血(ICH)的高危因素,建立预警评分系统。
    方法 纳入1 281例ANPL成人患者(模型组)和378例成人患者(验证组),所有患者均随访12月。模型组数据归纳ICH发生的相关因素并建立风险评分系统,验证组数据对风险评分系统进行验证(评分系统对验证组的每例患者进行评分,分为高、中、低风险),并通过绘制ROC曲线评价该评分系统的预测效能。
    结果 单、多因素分析表明,ANPL早期ICH的独立危险因素为WBC≥30.00×109/L、FIB < 2.92 g/L和PT≥12.91 s。用上述3个因素依据各自权重建立新的预警评分系统,该评分系统ROC曲线下面积为0.774(95%CI: 0.688~0.859)。验证组证实,该评分系统ROC曲线下面积为0.715(95%CI: 0.559~0.872)。
    结论 新建预警评分系统能较好预测ANPL早期ICH的发生,可指导临床及早识别潜在危重患者。

     

    Abstract:
    Objective To establish a simple and convenient early warning scoring system by retrospectively analyzing the high risk factors of early intracranial hemorrhage (ICH) in acute non-promyelocytic leukemia (ANPL) patients.
    Methods We enrolled 1281 adult patients with ANPL (model group) and 378 adult patients (validation group), all patients were followed up for 12 months respectively. We used the data of model group to summarize the relevant factors of ICH occurrence and established risk scoring system. The risk scoring system was validated by the data of the validation group (each patient in the validation group was scored by the scoring system and divided into high, medium and low risks groups). The prediction efficiency of the scoring system was evaluated by ROC curves.
    Results Univariate and multivariate analyses showed that the independent risk factors of early ICH in ANPL were WBC≥30.00×109/L, Fibrinogen(FIB) < 2.92 g/L and PT≥12.91 s. A new early warning scoring system was established based on the weights of the above three factors. The area under ROC curve of the scoring system was 0.774 (95%CI: 0.688-0.859). The area under the ROC curve of the scoring system was 0.715 (95%CI: 0.559-0.872) confirmed by the validation group.
    Conclusion The new early warning scoring system could predict the occurrence of early ICH in ANPL and guide the medical staff to identify potential critical patients as early as possible.

     

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