摘要
目的构建基于支气管定量特征的哮喘预测模型,为哮喘筛查提供新的辅助手段。方法选择2019年1月~12月就诊于郑州大学人民医院的22例慢性持续期哮喘患者及24例健康体检者,所有患者均行肺功能检查、胸部CT、呼出气一氧化氮(FeNO)及常规血液学检查,通过数字肺TM影像分析系统对患者CT中支气管树进行三维重建及特征量化,采用多因素logistic回归后退法(LR)筛选预测哮喘的独立危险因素,构建基于支气管定量特征的logistic风险预测模型,并评估模型准确度及稳定性。结果随着支气管代数的增加,哮喘组与对照组的管腔内面积(LA/BSA)、管壁横截面积(WA/BSA)、管腔内径(L/BSA)逐渐下降,管壁面积比(WA%)逐渐增加。在同代水平上,哮喘组LA/BSA、L/BSA小于对照组,T/D(%)、WA%大于对照组,在第六代及以后支气管差异有统计学意义(P<0.05)。Logistic回归分析得出哮喘的独立危险因素包括FeNO、过敏性鼻炎病史和T/D(%),外部验证ROC曲线下面积为0.808,敏感度为0.636,特异度为0.889。结论本研究构建的模型对预测哮喘具有较好的准确性和稳定性,可作为哮喘筛查的辅助手段。
Objective The objective of this research was to construct an asthma prediction model based on bronchial characteristics to provide a new auxiliary method for asthma screening.Methods Twenty-two patients with chronic persistent asthma and twenty-four healthy controls who visited Zhengzhou University People’s Hospital were selected.All patients underwent pulmonary function examination,chest CT scan,FeNO and routine hematologic examinations.Three-dimensional reconstruction and characteristic quantification of bronchial trees in CT of patients were performed by digital lungTM image analysis system.Multiple logistic regression backward method(LR)was used to screen the independent risk factors for asthma prediction and a logistic model was constructed.We also evaluated the accuracy and test effectiveness of this model.Results With the increase of bronchial generations,the lumen area(LA/BSA),wall area(WA/BSA),lumen inner diameter(L/BSA)of two groups gradually decreased,and the WA%gradually increased.On the level of the same generation,LA/BSA and L/BSA of the asthma group were smaller than those of the control group,T/D(%)and WA%of the asthma group were larger than those of the control group,and the differences between the two groups in the sixth and later bronchial were statistically significant(P<0.05).Logistic regression analysis showed that independent risk factors for asthma included FeNO,history of allergic rhinitis and T/D(%).The area under the ROC curve of external validation was 0.808,the sensitivity was 0.636,and the specificity was 0.889.Conclusion The model constructed in this study has good accuracy and stability,it can be used as an adjunct to asthma screening.
作者
赵幸汝
刘海洋
徐志伟
张晓菊
ZHAO Xing-ru;LIU Hai-yang;XU Zhi-wei;ZHANG Xiao-ju(Department of Respiratory and Critical Care Medicine,Zhengzhou University People’s Hospital,Zhengzhou 450003,China)
出处
《医药论坛杂志》
2021年第10期12-17,共6页
Journal of Medical Forum
