基于倾向得分匹配对垂体腺瘤卒中与侵袭性关系的研究

张豪, 程东东, 巨春雷, 郭建忠, 张刚利

张豪, 程东东, 巨春雷, 郭建忠, 张刚利. 基于倾向得分匹配对垂体腺瘤卒中与侵袭性关系的研究[J]. 实用临床医药杂志, 2021, 25(11): 13-17. DOI: 10.7619/jcmp.20210592
引用本文: 张豪, 程东东, 巨春雷, 郭建忠, 张刚利. 基于倾向得分匹配对垂体腺瘤卒中与侵袭性关系的研究[J]. 实用临床医药杂志, 2021, 25(11): 13-17. DOI: 10.7619/jcmp.20210592
ZHANG Hao, CHENG Dongdong, JU Chunlei, GUO Jianzhong, ZHANG Gangli. Investigation on relationship between pituitary denomaapoplexy and invasiveness of pituitary tumor based on propensity score matching method[J]. Journal of Clinical Medicine in Practice, 2021, 25(11): 13-17. DOI: 10.7619/jcmp.20210592
Citation: ZHANG Hao, CHENG Dongdong, JU Chunlei, GUO Jianzhong, ZHANG Gangli. Investigation on relationship between pituitary denomaapoplexy and invasiveness of pituitary tumor based on propensity score matching method[J]. Journal of Clinical Medicine in Practice, 2021, 25(11): 13-17. DOI: 10.7619/jcmp.20210592

基于倾向得分匹配对垂体腺瘤卒中与侵袭性关系的研究

基金项目: 

山西省卫生健康委员会科研项目 2019021

详细信息
    通讯作者:

    张刚利, E-mail: Zhanggangli1973@163.com

  • 中图分类号: R736.4;R445.2

Investigation on relationship between pituitary denomaapoplexy and invasiveness of pituitary tumor based on propensity score matching method

  • 摘要:
      目的  应用倾向性得分匹配方法分析垂体腺瘤卒中出血与垂体腺瘤大小及侵袭性的关系。
      方法  回顾性分析570例垂体腺瘤患者的临床资料,按照垂体腺瘤是否发生卒中出血将患者分为卒中组100例与非卒中组470例。使用倾向性得分匹配方法控制基线资料干扰因素后,将卒中组与非卒中组以1:1比例进行匹配,应用条件Logistic分析对垂体腺瘤出血卒中与垂体腺瘤侵袭性的关系进行分析。
      结果  匹配前,2组性别、年龄及Knosp分级比较,差异有统计学意义(P < 0.05)。匹配后,平衡混杂因素,2组基线资料差异无统计学意义(P>0.05)。二元条件Logistic回归分析结果显示,垂体腺瘤卒中出血与垂体腺瘤的侵袭性显著相关(P=0.008),而与垂体腺瘤大小无相关性(P=0.746)。不同Knosp分级中,Knosp 3级是垂体腺瘤卒中的危险因素(P=0.019)。
      结论  侵袭性垂体腺瘤易发生卒中出血,肿瘤大小并不是影响垂体腺瘤卒中出血的因素,Knosp 3级的垂体腺瘤较其他级别更易发生卒中出血。对于伴有海绵窦侵犯的垂体腺瘤患者来说,无论肿瘤大小均应尽早接受治疗。
    Abstract:
      Objective  To analyze the relationship between pituitary denoma apoplexy induced nemorrhage and invasiveness of pituitary tumor based on propensity score matching method.
      Methods  The clinical data of 570 patients with pituitary adenoma was retrospectively analyzed, and the patients were divided into stroke group (100 cases) and non-stroke group (470 cases) according to occurrence of hemorrhage caused by stroke of pituitary adenoma. After eliminating the interfering factors of baseline data by the method of propensity score matching method, the stroke group and the non-stroke group were matched in a 1:1 ratio, and the relationship between hemorrhage caused by stroke and pituitary adenoma invasion was analyzed by conditional Logistic analysis.
      Results  Before matching, there were statistically significant differences in gender, age and Knosp grading between the two groups (P < 0.05). After matching, after adjusting for confounding factors, there was no significant difference in baseline data between the two groups (P>0.05). The results of binary Logistic regression analysis showed that hemorrhage after pituitary adenoma stroke had significant correlation with the invasion of pituitary adenoma (P=0.008), but no correlation with the size of pituitary adenoma (P=0.746). Among different Knosp grading, Knosp grade 3 was a risk factor for pituitary adenoma stroke (P=0.019).
      Conclusion  Pituitary tumors with invasion and those in Knosp 3 grading are more prone to present hemorrhage. The size of the pituitary tumor does not affect apoplexy. Therefore, pituitary tumor patients with cavernous sinus invasion should accept the treatment as early as possible regardless of the size of the tumor.
  • 图  1   不同Knosp分级对垂体腺瘤卒中的影响

    表  1   垂体腺瘤患者匹配前后一般资料比较(x±s)[n(%)]

      一般资料 匹配前 匹配后
    卒中组(n=100) 非卒中组(n=470) P 卒中组(n=100) 非卒中组(n=100) P
    年龄/岁 53.90±12.27 50.82±12.60 0.026 53.90±12.27 53.54±11.68 0.832
    性别 63(63.00) 228(48.51) 0.008 63(63.00) 59(59.00) 0.562
    37(37.00) 242(51.49) 37(37.00) 41(41.00)
    复发垂体腺瘤 6(6.00) 56(11.91) 0.085 6(6.00) 8(8.00) 0.579
    94(94.00) 414(88.09) 94(94.00) 92(92.00)
    肿瘤直径/cm 2.83±1.09 2.68±1.25 0.412 2.83±1.09 2.65±1.11 0.260
    肿瘤分类 微腺瘤 1(1.00) 14(2.98) 0.258 1(1.00) 3(3.00) 0.143
    大腺瘤 86(86.00) 407(86.60) 86(86.00) 85(85.00)
    巨大腺瘤 13(13.00) 49(10.42) 13(13.00) 12(12.00)
    Knosp分级 0级 11(11.00) 80(17.02) < 0.001 11(11.00) 17(17.00) 0.029
    1级 19(19.00) 156(33.19) 19(19.00) 30(30.00)
    2级 14(14.00) 74(15.74) 14(14.00) 14(14.00)
    3级 35(35.00) 67(14.26) 35(35.00) 21(21.00)
    4级 21(21.00) 93(19.79) 21(21.00) 18(18.00)
    高血压病 25(25.00) 121(25.74) 0.877 25(25.00) 23(23.00) 0.741
    糖尿病 12(12.00) 41(8.72) 0.306 12(12.00) 13(13.00) 0.831
    激素异常 泌乳素 46(46.00) 180(38.30) 0.153 46(46.00) 98(98.00) < 0.001
    睾酮 17(17.00) 114(24.36) 0.686 17(17.00) 12(12.00) 0.315
    生长激素 17(17.00) 88(17.82) 0.113 17(17.00) 31(31.00) 0.020
    下载: 导出CSV

    表  2   垂体腺瘤患者常见症状比较[n(%)]

      症状 总体(n=570) 卒中组(n=100) 非卒中组(n=470) P
    头痛 203(35.61) 56(56.00) 147(31.28) < 0.001
    恶心 65(11.40) 23(23.00) 42(8.94) < 0.001
    头晕 138(25.50) 31(31.00) 107(22.77) 0.081
    眼肌麻痹 70(12.28) 31(31.00) 39(8.30) < 0.001
    视物模糊 单侧 106(18.60) 23(23.00) 83(17.66) 0.007
    双侧 243(42.63) 51(51.00) 192(40.85)
    视野缺损 单侧 76(13.33) 21(21.00) 55(11.70) < 0.001
    双侧 113(19.82) 32(32.00) 81(17.23)
    意识障碍 17(2.98) 14(14.00) 3(0.64) < 0.001
    面容改变 68(11.93) 6(6.00) 62(13.19) 0.044
    月经紊乱 12(4.30) 2(5.41) 10(4.13) 0.722
    溢乳 25(4.39) 4(4.00) 21(4.47) 0.836
    月经紊乱发生率仅基于女性例数计算。
    下载: 导出CSV

    表  3   垂体腺瘤卒中影响因素的条件Logistic回归分析

      变量 调整前 调整后
    OR 95%CI P OR 95%CI P
    垂体腺瘤侵袭性 2.69 1.29~5.60 0.008 2.54 1.34~4.82 0.004
    垂体腺瘤大小 0.95 0.69~1.30 0.746 - - -
    -为剔除变量,未纳入分析。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2021-02-02
  • 网络出版日期:  2021-06-14
  • 发布日期:  2021-06-14

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