| Objective: It can assess the risk factors of thrombosis,which is of great significance for the early intervention of high-risk population of chronic pulmonary heart disease,and can significantly reduce the mortality.It can predict the specific sensitive value of independent risk factors,and has an early warning effect on the risk of thrombosis for people higher than the sensitive value in clinical work.Methods: Through the digital case system,60 patients with chronic pulmonary heart disease(CPHD)complicated with pulmonary thromboembolism admitted by Qinzhou First People’s Hospital,Qinzhou Second People’s Hospital and Hepu County People’s Hospital from January 1,2020 to April 30,2022,who met the inclusion criteria,were collected by random sampling method as the research object,and Caprini Thrombus Assessment Scale was used to score CPHD patients,It shows that the patients with CPHD included in the study are all high risk group and extremely high risk group,and there is no middle low risk group.The classified variables in this study are binary variables,which are brought into single factor and multifactor binary logistic regression analysis respectively.The specific method is to bring the sex,age,body mass index(BMI),smoking history,white blood cell count(WBC)and other data of CPHD patients into the single factor and multi factor binary logistic regression analysis respectively,so as to make the independent risk factors of pulmonary embolism in patients with chronic pulmonary heart disease.The working characteristic curve of ROC subjects with independent risk factors on the risk of pulmonary embolism was made,and the sensitivity and specificity were made,as well as the sensitivity value.The difference of thrombus risk between the two groups was compared according to the grouping of sensitive values.Compare the proportion of people with high risk of thrombosis between the two groups,and compare and analyze the statistical differences of other variables between the two groups.Results:(1)There was no significant difference in sex,BMI,smoking history and C-reactive protein(CRP)among CPHD patients(P>0.05).Univariate analysis showed that D-dimer,hemoglobin(HB)value,duration of cor pulmonale,age,WBC value,PO2 value,PLT value significantly affected the risk of thrombosis(P<0.05).After excluding the confounding factors,the results of multifactor analysis showed that D-dimer,hemoglobin(HB)and the course of cor pulmonale were independent risk factors of thrombosis risk(P<0.05).(2)The working characteristic curves of ROC subjects were made respectively for D-dimer,HB and cor pulmonale on whether the course of disease was a very high risk of thrombosis.The results indicated that HB had a good sensitivity and specificity in predicting the risk of thrombosis.Further,the Joden index was made.The maximum value of the Joden index was0.346,and the corresponding hemoglobin value was 145g/L.(3)Further validation,according to the sensitive value of HB,it was divided into two subgroups,group 1(HB<145g/L)and group 2(HB ≥ 145g/L).The proportion of people with high risk of thrombosis in the two groups was compared,and the statistical differences of other variables in the two groups were compared and analyzed.Conclusion:(1)Sex,BMI and smoking history are not independent risk factors for PTE in patients with CPHD.(2)Age,WBC value,PO2 value,PLT value significantly affected the risk of thrombosis.HB,D-dimer,and the course of cor pulmonale were independent risk factors of PTE in patients with CPHD.(3)D-dimer and the course of cor pulmonale can not predict the extremely high risk of thrombosis significantly and sensitively,while HB can predict the extremely high risk of thrombosis significantly and sensitively,with high sensitivity and specificity.HB ≥ 145g/L has a higher probability of extremely high risk of thrombosis. |
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