摘要
目的基于多元Logistic回归方法建立缺血性中风病恢复期肾虚证证候诊断模型。方法通过前瞻性、多中心、动态采集的四诊信息调查,分别在15个分中心纳入符合纳入和排除标准的缺血性中风恢复期患者181例,共得到完整采集的数据信息970例次。利用多元Logistic回归构建肾虚证诊断模型,并通过ROC曲线进行效能判别。结果筛选出颧红、腰酸、小便频、健忘、脉弱、潮热、膝软、五心烦热、精神萎靡、腰冷、小便清长、脉沉细等12个因素,是缺血性中风恢复期肾虚证成立的相关因素,并构建诊断模型:P=1/[1+Exp(11.223-2.002×颧红-1.861×腰酸-1.738×小便频-1.494×健忘-1.469×脉弱-1.361×潮热-1.297×膝软-1.181×五心烦热-1.028×精神萎靡-0.742×腰冷-0.722×小便清长-0.594×脉沉细)],预测函数模型ROC曲线下面积为0.946,尤登指数为0.766,该诊断模型敏感度为90.5%,特异度为85.4%,同样本的验证诊断一致度为84.1%。结论通过多元Logistic回归分析,构建基于四诊信息的缺血性中风恢复期肾虚证诊断模型,为缺血性中风恢复期肾虚证辨识提供参考工具。
Objective To establish the diagnosis model of kidney deficiency syndrome in the convalescent period of ischemic stroke based on multivariate logistic regression.Methods For a prospective, multi-center, dynamic collection of the four-examination information, 181 patients with ischemic stroke in the recovery period who met the inclusion criteria were recruited in 15 centers, and a total of 970 complete data sets were obtained. The diagnostic model of kidney deficiency syndrome was constructed by multiple logistic regression, and the efficacy was evaluated by ROC curve.Results Twelve factors, including hectic cheek, soreness of waist, frequent urination, amnesia, weak pulse, hot flushes, knee weakness, vexing heat in the five centers(chest, palms and soles), mental fatigue, cold waist, clear abundant urine, and deep and thready pulse, were screened out as the relevant factors for the establishment of kidney deficiency syndrome in the recovery period of ischemic stroke, and a diagnostic model was established: P = 1/[1+Exp(11.223-2.002×hectic cheek-1.861×soreness of waist-1.738×frequency of urination-1.494×amnesia-1.469×weak pulse-1.361×hot flushes-1.297×knee weakness-1.181×vexing heat in the five centers-1.028×mental fatigue-0.742× cold waist-0.722×clear abundant urine-0.594×deep and thready pulse)]. The area under the ROC curve in the predictive function model was 0.946, the Youden index was 0.766, the sensitivity was 90.5%, the specificity was 85.4%, and the diagnostic consistency of the same sample was 84.1%.Conclusion Through the multivariate logistic regression analysis, a diagnosis model of kidney deficiency syndrome in the recovery period of ischemic stroke was constructed based on the information of the four examinations, providing a tool for the condition.
作者
董兴鲁
高颖
唐璐
郭盛楠
刘强
周莉
DONG Xinglu;GAO Ying;TANG Lu;GUO Shengnan;LIU Qiang;ZHOU Li(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;Institute for Brain Disorders,Beijing University of Chinese Medicine;Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences;Center for Evidence Based Medicine and Clinical Research,World Federation of Chinese Medicine Societies)
出处
《现代中医临床》
2023年第1期26-30,共5页
Modern Chinese Clinical Medicine
基金
国家科技重大专项课题(No.2017ZX09304019)
北京市中医管理局委托项目。
关键词
缺血性中风恢复期
肾虚证
多元LOGISTIC回归
ROC曲线
诊断量表
recovery period of ischemic stroke
kidney deficiency syndrome
multivariate logistic regression
ROC curve
diagnostic scale
作者简介
董兴鲁,男,在读博士生;通信作者:周莉,女,博士,主任医师,硕士生导师,E-mail:zhouljk7211@163.com。
