红细胞分布宽度在癌症患者外周静脉穿刺中心静脉导管（PICC）相关血栓形成诊断中的预测价值
Predictive Value of Red Cell Distribution Width in the Diagnosis of Peripherally Inserted Central Catheter (PICC)-Related Thrombosis Among Cancer Patients.
作者信息
Zhai Rui, Chen Xiaojie, Wang Guodong, Xu Jiaxuan, Yang Yong
机构信息
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Critical Care Medicine, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China.
出版信息
Int J Gen Med. 2023 Jan 31;16:359-365. doi: 10.2147/IJGM.S395745. eCollection 2023.
PURPOSE
This study aimed to investigate the predictive value of red cell distribution width (RDW) in patients with peripherally inserted central catheter (PICC)-related thrombosis.
PATIENTS AND METHODS
This was a case‒control study. A total of 98 cancer patients undergoing PICC placement from January 2017 to December 2019 at the ICU Venous Access Center of Peking University Cancer Hospital were retrospectively analyzed. These included 47 cases in the thrombosis group and 51 cases in the nonthrombosis group according to the occurrence of PICC-related thrombosis within 90 days after the PICC procedure.
RESULTS
a) RDW was significantly higher in the thrombosis group (15.98±1.93) than in the nonthrombosis group (13.98±1.09). Additionally, the number of smoking histories in the thrombosis group (18, 38.30%) was significantly higher than that in the nonthrombosis group (5, 9.80%). b) Logistic regression analysis indicated that RDW and smoking history were independent risk factors for PICC-related thrombosis (OR: 3.028, P<0.001; OR: 5.640, P=0.023). c) The area under the receiver operating characteristic (ROC) curve of the combination of RDW and smoking history was 86.8%, and the sensitivity and specificity for predicting thrombosis after PICC were 85.1% and 80%, respectively. d) Cox regression analysis revealed that RDW and smoking history were independent risk factors for PICC-related thrombosis (p<0.001). e) Results from Kaplan‒Meier analysis showed that incidence of PICC-related thrombosis in patients with RDW less than 14.75% is significantly lower than those with RDW 14.75% and above (p<0.001). e) Baseline RDW was not different between the two groups (P>0.05), ΔRDW was significantly different between the two groups (p<0.001).
CONCLUSION
The combined use of RDW and smoking history has early evaluation and predictive value in the diagnosis of PICC-related thrombosis.
目的
本研究旨在探讨红细胞分布宽度（RDW）在经外周静脉穿刺中心静脉置管（PICC）相关血栓形成患者中的预测价值。
患者与方法
这是一项病例对照研究。回顾性分析了2017年1月至2019年12月在北京大学肿瘤医院重症监护室静脉通路中心接受PICC置管的98例癌症患者。根据PICC置管术后90天内是否发生PICC相关血栓形成，将其分为血栓形成组47例和非血栓形成组51例。
结果
a）血栓形成组的RDW（15.98±1.93）显著高于非血栓形成组（13.98±1.09）。此外，血栓形成组有吸烟史的人数（18例，38.30%）显著高于非血栓形成组（5例，9.80%）。b）Logistic回归分析表明，RDW和吸烟史是PICC相关血栓形成的独立危险因素（OR：3.028，P<0.001；OR：5.640，P=0.023）。c）RDW与吸烟史联合检测的受试者工作特征（ROC）曲线下面积为86.8%，预测PICC术后血栓形成的灵敏度和特异度分别为85.1%和80%。d）Cox回归分析显示，RDW和吸烟史是PICC相关血栓形成的独立危险因素（p<0.001）。e）Kaplan-Meier分析结果显示，RDW低于14.75%的患者PICC相关血栓形成的发生率显著低于RDW为14.75%及以上的患者（p<0.001）。e）两组患者的基线RDW无差异（P>0.05），两组间的ΔRDW有显著差异（p<0.001）。
结论
RDW与吸烟史联合应用对PICC相关血栓形成的诊断具有早期评估和预测价值。
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