摘要
目的分析老年高血压患者发生衰弱的影响因素并构建列线图预测模型。方法随机选取老年高血压患者380例作为研究对象,根据患者是否发生衰弱将患者分为衰弱组(120例)和非衰弱组(260例)。比较两组患者的临床资料,通过ROC曲线分析获取各因素的最佳截断值,构建预测老年高血压患者发生衰弱的影响因素的列线图模型,并采用决策曲线评估列线图模型的预测效能。结果衰弱组患者的年龄、高血压病程、合并症数量、同型半胱氨酸(Hcy)水平、白细胞介素-6(IL-6)水平、单核细胞趋化蛋白-1(MCP-1)水平、可溶性细胞黏附因子-1(sl-CAM-1)水平和营养状态不良情况比例均高于非衰弱组,差异均有统计学意义(t分别=-8.12、-40.45、-41.19、-24.77、-36.21、-25.63、-14.53,χ^(2)=10.77,P均<0.05)。年龄(≥75岁)、高血压病程(≥5年)、合并症数量(≥4个)、Hcy(≥15μmol/L)、IL-6(≥250 ng/ml)、MCP-1(≥30 pg/ml)、slCAM-1(≥3 pg/ml)是老年高血压患者发生衰弱的影响因素(OR分别=1.76、1.69、1.37、1.87、1.64、1.49、1.13,P均<0.05)。此列线图模型预测老年高血压患者发生衰弱的影响因素的校正曲线趋于理想曲线;决策曲线结果显示,当高风险阈值>0.17时,此列线图模型所提供的临床净收益均高于单个独立影响因素并且在预测老年高血压患者发生衰弱的影响因素方面可提供显著的额外临床净收益。结论基于独立影响因素所构的建列线图模型在识别老年高血压患者发生衰弱的影响因素方面有着较好的临床效能。
Objective To analyze the influencing factors of weakness in elderly patients with hypertension and build a nomogram prediction model.Methods A total of 380 elderly patients with hypertension were randomly selected,and divid-ed into weakness group(120 cases)and non weakness group(260 cases)according to whether the patients had weakness.The clinical data of the two groups were compared,cut-off value of each factor was obtained through ROC curve,thus to build a nomogram model to predict the influencing factors of weakness in elderly patients with hypertension,and use the de-cision curve to evaluate the prediction efficiency of the nomogram model.Results The age,course of hypertension,number of complications,Hcy,IL-6,MCP-1,slCAM-1 levels and the proportion of malnutrition in the weakness group were signifi-cantly higher than those in the non weakness group(t=-8.12,-40.45,-41.19,-24.77,-36.21,-25.63,-14.53,χ^(2)=10.77,P<0.05),age(≥75 years),course of hypertension(≥5 years),number of complications(≥4),Hcy(≥15μmol/L),IL-6(≥250 ng/ml),MCP-1(≥30 pg/ml)and slCAM-1(≥3 pg/ml)were the influencing factors of debility in elderly patients with hypertension(OR=1.76,1.69,1.37,1.87,1.64,1.49,1.13,P<0.05).The correction curve of this nomogram model for predict-ing the influencing factors of debility in elderly patients with hypertension tends to an ideal curve.The decision curve results show that when the high risk threshold is higher than 0.17,the clinical net benefit provided by this nomogram model is high-er than that of a single independent influencing factor,and it can provide significant additional clinical net benefit in pre-dicting the influencing factors of decline in elderly patients with hypertension.Conclusion The constructive line graph model based on independent influencing factors has good clinical efficacy in identifying the influencing factors of weakness in elderly patients with hypertension.
作者
肖丹
XIAO Dan(Department of Geriatrics,Kecheng District People's Hospital,Quzhou 324000,China)
出处
《全科医学临床与教育》
2022年第7期617-620,F0003,共5页
Clinical Education of General Practice
关键词
老年高血压患者
衰弱
影响因素
列线图
预测模型
elderly patients with hypertension
weakness
influencing factors
nomogram
pre-diction model
