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血红蛋白、白蛋白、淋巴细胞及血小板评分在预测接受外周静脉穿刺中心静脉置管患者血栓性静脉炎中的作用。

Role of the hemoglobin, albumin, lymphocyte, and platelet score in predicting thrombophlebitis among patients undergoing peripherally inserted central catheter.

作者信息

Shi Yujing, Zhan Zhangli, Ju Mengyang, Yang Ling, Chen Xiaojiao, Liang Liang, Ge Xiaolin, Zhu Caiqiang, Sun Xinchen, Di Xiaoke, He Chenghong

机构信息

Department of Oncology, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang, Jiangsu, China.

Department of Radiation Oncology, Osaka University, Suita, Osaka, Japan.

出版信息

Medicine (Baltimore). 2024 Dec 6;103(49):e40520. doi: 10.1097/MD.0000000000040520.

Abstract

This study analyzes the role of the hemoglobin, albumin, lymphocyte, and platelet score (HALP), a pre-catheterization blood parameter, in predicting the occurrence of thrombophlebitis. We recruited 268 in-hospital patients who visited the Department of Oncology of our hospital and underwent peripherally inserted central catheter between January 2021 and January 2024. The cutoff value of the HALP score was defined using receiver's operating characteristic curve, and the differences were analyzed with log-rank test. The significance of HALP in predicting thrombophlebitis was evaluated using a multivariate Cox proportional hazards model. A total of 240 patients were enrolled and divided into a high-HALP (≥31.4) group (n = 125) and a low-HALP (<31.4) group (n = 115). The relationship between the composition of HALP and clinical pathological parameters was analyzed. HALP was significantly correlated with gender (X2 = 4.74), limb restriction (X2 = 3.69), performance status score (X2 = 11.9), D-dimer (X2 = 7.88), and platelet count (X2 = 5.22). Multivariate regression analysis found male (hazard ratio [HR] 0.29 (0.12-0.69)), more puncture times (HR 0.01 (0.001-0.15)), lower HALP (HR 1.93 (0.82-4.52)), and sterile couplant (HR 20.6 (4.7-91.2)) were independent factors affecting the occurrence of thrombophlebitis. Receiver's operating characteristic curve analysis showed the area under the curve of the HALP score was 0.718 (95% confidence interval 0.638-0.798), which was significantly larger than the other 3 parameters. Hence, we believe the predictive efficiency of HALP is higher than other parameters. The pre-catheterization HALP score can be used as a simple, accessible, and reliable tool for predicting thrombophlebitis in patients to undergo peripherally inserted central catheter.

摘要

本研究分析了血红蛋白、白蛋白、淋巴细胞和血小板评分(HALP)这一置管前血液参数在预测血栓性静脉炎发生中的作用。我们招募了268例在我院肿瘤内科就诊并于2021年1月至2024年1月期间接受外周静脉穿刺中心静脉置管的住院患者。使用受试者工作特征曲线确定HALP评分的临界值,并采用对数秩检验分析差异。使用多变量Cox比例风险模型评估HALP在预测血栓性静脉炎中的意义。共有240例患者入组并分为高HALP(≥31.4)组(n = 125)和低HALP(<31.4)组(n = 115)。分析了HALP的组成与临床病理参数之间的关系。HALP与性别(X2 = 4.74)、肢体限制(X2 = 3.69)、体能状态评分(X2 = 11.9)、D - 二聚体(X2 = 7.88)和血小板计数(X2 = 5.22)显著相关。多变量回归分析发现男性(风险比[HR] 0.29(0.12 - 0.69))、穿刺次数更多(HR 0.01(0.001 - 0.15))、HALP较低(HR 1.93(0.82 - 4.52))和使用无菌耦合剂(HR 20.6(4.7 - 91.2))是影响血栓性静脉炎发生的独立因素。受试者工作特征曲线分析显示HALP评分的曲线下面积为0.718(95%置信区间0.638 - 0.798),显著大于其他3个参数。因此,我们认为HALP的预测效率高于其他参数。置管前HALP评分可作为预测接受外周静脉穿刺中心静脉置管患者血栓性静脉炎的一种简单、可及且可靠的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6415/11630945/7efb6f59d0f3/medi-103-e40520-g001.jpg

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