[1]赵思捷,余 航,党珮珠,等.多发性骨髓瘤患者合并心包积液危险因素分析及列线图预测模型构建[J].陕西医学杂志,2024,(12):1635-1639.[doi:DOI:10.3969/j.issn.1000-7377.2024.12.009]
　ZHAO Sijie,YU Hang,DANG Peizhu,et al.Risk factors of multiple myeloma patients with pericardial effusion and construction of nomogram prediction model[J].,2024,(12):1635-1639.[doi:DOI:10.3969/j.issn.1000-7377.2024.12.009]
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多发性骨髓瘤患者合并心包积液危险因素分析及列线图预测模型构建
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年12期
页码:
1635-1639
栏目:
临床研究
出版日期:
2024-12-05

文章信息/Info

Title:
Risk factors of multiple myeloma patients with pericardial effusion and construction of nomogram prediction model
作者:
赵思捷1; 余 航2; 党珮珠2; 王海洋3; 董 杨3; 贺鹏程1
(1.西安交通大学第一附属医院血液内科,陕西 西安 710061; 2.西安交通大学第一附属医院心血管内科,陕西 西安 710061; 3.西安交通大学第一附属医院心血管外科,陕西 西安 710061)
Author(s):
ZHAO Sijie; YU Hang; DANG Peizhu; WANG Haiyang; DONG Yang; HE Pengcheng
(Department of Hematology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)
关键词:
多发性骨髓瘤;  心包积液;  危险因素;  列线图模型;  校准曲线
Keywords:
Multiple myeloma;  Pericardial effusion;  Risk factor;  Nomogram model;  Calibration curve
分类号:
R 733.3
DOI:
DOI:10.3969/j.issn.1000-7377.2024.12.009
文献标志码:
A
摘要:
目的:探究多发性骨髓瘤(MM)患者合并心包积液的危险因素并构建列线图预测模型。方法:纳入MM患者238例,根据有无心包积液分为心包积液组(39例)和非心包积液组(199例)。比较两组患者临床资料和实验室指标,分析合并心包积液的影响因素,构建列线图模型并使用受试者工作特征(ROC)曲线和校准曲线评估模型预测效能。结果:与非心包积液组比较,心包积液组女性、ISS Ⅲ期及合并高血压占比以及D-二聚体水平更高,入院收缩压更低(均P<0.05)。Logistic回归分析显示,女性、合并高血压、D-二聚体升高和MM国际分级体系(ISS)Ⅲ期为MM患者合并心包积液的独立危险因素,入院收缩压升高为MM患者发生心包积液的保护因素(均P<0.05)。将性别、入院时收缩压、高血压、D-二聚体及ISS分期作为预测因子构建列线图预测模型,ROC曲线和校准曲线显示该模型具有良好的预测能效和判别能力。结论:女性、合并高血压、D-二聚体升高和ISS Ⅲ期为MM患者合并心包积液的独立危险因素,依据这些因素构建的列线图模型能够有效预测患者合并心包积液的风险。
Abstract:
Objective:To investigate the risk factors of multiple myeloma(MM)patients with pericardial effusion and to construct a nomogram prediction model.Methods:A total of 238 MM patients were enrolled and divided into pericardial effusion group(39 cases)and non-pericardial effusion group(199 cases)according to the presence or absence of pericardial effusion.The clinical data and laboratory indexes of the two groups were compared,and the influencing factors of pericardial effusion were analyzed.A nomogram model was constructed,and ROC curve and calibration curve were used to evaluate the predictive efficacy of the model.Results:Compared with the non-pericardial effusion group,the pericardial effusion group had a higher proportion of women,ISS stage Ⅲ,hypertension,and D-dimer level,and a lower systolic blood pressure on admission(all P<0.05).Logistic regression analysis showed that female,hypertension,elevated D-dimer and ISS stage Ⅲ were independent risk factors for MM patients with pericardial effusion,and elevated systolic blood pressure on admission was a protective factor(all P<0.05).Gender,systolic blood pressure on admission,hypertension,D-dimer and ISS stage were used as predictors to construct a nomogram prediction model.ROC curve and calibration curve showed that the model had good predictive energy efficiency and discrimination ability.Conclusion:Female,hypertension,elevated D-dimer and ISS stage Ⅲ are independent risk factors of MM patients with pericardial effusion.The nomogram model based on these risk factors can effectively predict the risk of pericardial effusion in MM patients.

参考文献/References:

[1] RÍOS-TAMAYO R,KRSNIK I,GÓMEZ-BUENO M,et al.AL amyloidosis and multiple myeloma:A complex scenario in which cardiac involvement remains the key prognostic factor[J].Life(Basel),2023,13(7):1518.
[2] RAJKUMAR S V,DIMOPOULOS M A,PALUMBO A,et al.International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma[J].Lancet Oncol,2014,15(12):e538-e548.
[3] 郭艳珍,张治业,高晓会,等.中西医结合治疗多发性骨髓瘤31例[J].陕西中医,2005,26(6):490-491.
[4] 冯传杰,吴英杰.多发性骨髓瘤36例临床分析[J].陕西医学杂志,2017,46(5):595-596,673.
[5] 于冬雯,郑炜,杨瑛,等.多发性骨髓瘤超声心动图及心脏损害的临床研究[J].陕西医学杂志,2016,45(4):440-441.
[6] LOUKHNATI M,LAHLIMI F E,TAZI I.Cardiac tamponade as first manifestation of multiple myeloma:A case report with literature review[J].Ann Cardiol Angeiol(Paris),2023,72(4):101613.
[7] PRICE S,PROUT J,JAGGAR S I,et al.Tamponade following cardiac surgery:Terminology and echocardiography may both mislead[J].Eur J Cardiothorac Surg,2004,26(6):1156-1160.
[8] KUMAR S K,CALLANDER N S,HILLENGASS J,et al.NCCN guidelines insights:Multiple myeloma,version 1.2020[J].J Natl Compr Canc Netw,2019,17(10):1154-1165.
[9] YAMANI N,ABBASI A,ALMAS T,et al.Diagnosis,treatment,and management of pericardial effusion-review[J].Ann Med Surg(Lond),2022,80:104142.
[10] MCQUILLAN B M,PICARD M H,LEAVITT M,et al.Clinical correlates and reference intervals for pulmonary artery systolic pressure among echocardiographically normal subjects[J].Circulation,2001,104(23):2797-2802.
[11] OHLOW M A,LAUER B,BRUNELLI M,et al.Incidence and predictors of pericardial effusion after permanent heart rhythm device implantation:Prospective evaluation of 968 consecutive patients[J].Circ J,2013,77(4):975-981.
[12] 翟蒙藏,张文宗,张鸣.保元逐瘀护心汤对老年冠心病合并高血压患者血压、心功能及Salusin-β、TNF-α、CRP水平的影响[J].陕西中医,2024,45(4):494-497.
[13] SCHMIEDER R E,MESSERLI F H.Hypertension and the heart[J].J Hum Hypertens,000,14(10-11):597-604.
[14] 翟向红.老年原发性高血压患者动态血压变异性及其与心脏结构、泵血功能的关系[J].河南医学研究,2024,33(12):2164-2168.
[15] 孙黎明,夏晓露,马红萍.高尿酸血症与高血压及心血管疾病关系研究进展[J].陕西医学杂志,2024,53(2):286-289.
[16] 王强,牛津津,周亚非,等.沙库巴曲缬沙坦钠片联合维立西呱治疗慢性心力衰竭的效果及对患者心功能、心脏结构重塑、血管内皮功能的影响[J].海南医学,2024,35(14):1991-1996.
[17] 李冀,王托资,付强.从“辰酉时”辨治高血压病探析[J].陕西中医,2022,43(3):338-341.
[18] 师勇,田龙,王萍.多发性骨髓瘤32例磁共振显像分型与临床分期对比分析[J].陕西医学杂志,2016,45(11):1499-1501.
[19] ROMANO A,PARRINELLO N L,CONSOLI M L,et al.Neutrophil to lymphocyte ratio(NLR)improves the risk assessment of ISS staging in newly diagnosed MM patients treated upfront with novel agents[J].Ann Hematol,2015,94(11):1875-1883.
[20] 孙洪侠,吴维霞,邢明泉.全身低剂量CT骨扫描联合MRI在多发性骨髓瘤诊断、分期及分型中的价值分析[J].临床和实验医学杂志,2024,23(10):1094-1098.
[21] GRIFONI S,OLIVOTTO I,CECCHINI P,et al.Short-term clinical outcome of patients with acute pulmonary embolism,normal blood pressure,and echocardiographic right ventricular dysfunction[J].Circulation,2000,101(24):2817-2822.
[22] 宋伟.血清纤维蛋白原、D-二聚体联合Hcy对非瓣膜性心房颤动患者血栓栓塞事件的预测价值[J].心血管病防治知识,2024,14(6):28-31.
[23] 周晓云,王琛,顾若琪,等.白蛋白、D-二聚体、中性粒细胞、血小板淋巴细胞比值及血小板计数对社区获得性肺炎严重程度的诊断价值[J].陕西医学杂志,2024,53(1):104-108.
[24] 赵贺红,李群.不同病情严重程度急性肺栓塞患者血清和肽素、白细胞介素-38、单核细胞计数/高密度脂蛋白胆固醇、D-二聚体/纤维蛋白原变化及预后影响因素分析[J].陕西医学杂志,2023,52(9):1186-1190.
[25] 庞海江.通脉逐瘀方联合阿司匹林治疗肺心病急性加重期合并全身炎症反应综合征疗效及对患者血浆D-二聚体、IL-6、BNP的影响[J].陕西中医,2018,39(7):873-875.
[26] 张庆勇,余良芳,罗宇成,等.D-二聚体阳性患者在临床科室的分布及相关疾病的分析[J].巴楚医学,2020,3(1):58-60,64.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(81270236)
更新日期/Last Update: 2024-12-05