心肺肾功能对慢性贫血患者红细胞输注阈值的影响：基于线性回归与倾向性评分匹配*

doi:10.3969/j.issn.1671-2587.2023.02.012

临床输血与检验 ›› 2023, Vol. 25 ›› Issue (2): 220-224.DOI: 10.3969/j.issn.1671-2587.2023.02.012

心肺肾功能对慢性贫血患者红细胞输注阈值的影响：基于线性回归与倾向性评分匹配^*

黎敏, 谭金哲, 程福, 秦莉

610041 四川成都,四川大学华西医院输血科（黎敏,谭金哲,程福,秦莉）; 四川天府新区人民医院输血科（黎敏）

收稿日期:2022-12-18 发布日期:2023-04-25
通讯作者: 秦莉,女,主任医师,硕士研究生导师,主要从事血液疾病和临床输血方面的研究,（E-mail）qinli7@126.com。
作者简介:黎敏,主要从事临床输血医学相关研究,（E-mail）478833808@qq.com。
基金资助:
*本课题受成都市医学科研课题（No.2022521）资助

Effect of Cardiopulmonary and Renal Function on Erythrocyte Infusion Threshold in Patients with Chronic Anemia: Based on Linear Regression and Propensity Score Matching

LI Min, TAN Jin-zhe, CHENG Fu, et al

Department of Blood Transfusion, West China Hospital, Sichuan University Chengdu 610041

Received:2022-12-18 Published:2023-04-25

摘要/Abstract

摘要： 目的探究心肺肾功能对慢性贫血患者红细胞输注阈值的影响,为临床输血前评估提供参考依据。方法收集本院临床2020~2021年979例慢性贫血输血患者基本信息,包括患者性别、年龄、左室射血分数、二氧化碳分压、肾小球滤过率估值、输血前血红蛋白浓度等指标。通过多元线性回归分析与倾向性评分匹配研究影响红细胞输注阈值的危险因素。结果对979例输血患者进行多元线性回归分析显示影响红细胞输注阈值的独立危险因素为年龄、二氧化碳分压,B值分别为-0.181、0.296,P<0.01。回归模型R²为0.072、VIF值均小于2、DW值为0.533,模型自变量独立性好,无共线性问题且残差符合正态分布。对290例肾功能衰竭组进行评分匹配后,其中268例匹配成功,匹配成功的肾功能衰竭组与肾功能正常组输血前血红蛋白浓度均值分别为57.74、68.88, F值为24.90 ,P<0.01。结论本研究提示年龄、肺功能以及肾功能均能影响患者红细胞输注阈值,其中年龄增大、肾功能衰竭患者均会使红细胞输注阈值降低;二氧化碳分压升高会使红细胞输注阈值升高;左心射血分数对红细胞输注阈值影响无统计差异。

关键词: 红细胞输注阈值, 线性回归, 倾向评分匹配

Abstract: Objective To explore the effect of cardio-pulmonary and renal function on erythrocyte transfusion threshold in patients with chronic anemia, and provide reference basis for clinical pre-transfusion evaluation. Methods The basic information of 979 patients with chronic anemia undergoing blood transfusion in our hospital from 2020 to 2021 was collected, including the patient's sex, age, left ventricular ejection fraction, partial pressure of carbon dioxide, glomerular filtration rate estimation, hemoglobin concentration before blood transfusion and other indicators. Multiple linear regression analysis and propensity score matching were used to study the risk factors affecting the red blood cell infusion threshold. Results The multiple linear regression analysis of 979 patients with blood transfusion showed that the independent risk factors affecting the threshold of red blood cell transfusion were age and partial pressure of carbon dioxide, and the B values were -0.181 and 0.296, respectively, P<0.01. The R² of the regression model is 0.072, the VIF value is less than 2, and the DW value is 0.533. The independent variables of the model are good, there is no collinearity problem, and the residual conforms to the normal distribution. After score matching of 290 cases of renal failure group, 268 cases were matched successfully. The mean hemoglobin concentration before blood transfusion in the matched renal failure group and the normal renal function group were 57.74 and 68.88, respectively, and the F value was 24.90, P<0.01. Conclusion This study suggests that age, lung function and renal function can affect the red blood cell infusion threshold of patients, and the increase of age and renal failure can reduce the red blood cell infusion threshold; The increase of partial pressure of carbon dioxide will increase the threshold of red blood cell infusion; There was no statistical difference in the effect of left ventricular ejection fraction on red blood cell infusion threshold.

Key words: Erythrocyte infusion threshold, Linear regression, Tendency score matching

中图分类号:

R331.1

黎敏, 谭金哲, 程福, 秦莉. 心肺肾功能对慢性贫血患者红细胞输注阈值的影响：基于线性回归与倾向性评分匹配^*[J]. 临床输血与检验, 2023, 25(2): 220-224.

LI Min, TAN Jin-zhe, CHENG Fu, et al. Effect of Cardiopulmonary and Renal Function on Erythrocyte Infusion Threshold in Patients with Chronic Anemia: Based on Linear Regression and Propensity Score Matching[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2023, 25(2): 220-224.

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心肺肾功能对慢性贫血患者红细胞输注阈值的影响：基于线性回归与倾向性评分匹配^*

Effect of Cardiopulmonary and Renal Function on Erythrocyte Infusion Threshold in Patients with Chronic Anemia: Based on Linear Regression and Propensity Score Matching

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