摘要
目的 利用临床常见资料构建自体动静脉内瘘(AVF)维持性血液透析患者发生腹主动脉钙化(AAC)的列线图预测模型。方法 选取2019年1月—2022年10月山东大学齐鲁医院血液净化中心的维持性血液透析患者175例,依据其是否发生AAC分为AAC组(140例)和非AAC组(35例),收集所有患者一般资料和相关实验室检查信息以构建列线图预测模型。结果 AAC组血压、维持透析时间、Hb、红细胞压积(HCT)较非AAC组更高(P<0.05)。依据Lasso回归分析筛选出年龄、患有糖尿病、BMI、舒张压、维持透析时间、Hb、甲状旁腺激素(PTH)、白蛋白(Alb)、总铁结合力(TIBC)构建了发生AAC的列线图预测模型,ROC下面积(AUC)为0.84[95%CI(0.76, 0.89)],模型精准率为0.96。决策曲线(DCA)提示使用该模型能够使患者获益度增加,校准曲线(CA)提示该模型预测结果与实际结果一致性良好。结论 基于Lasso回归筛选预测变量构建AVF维持性血液透析患者发生AAC的列线图预测模型,该模型有良好的准确率和区分度,为维持性血液透析患者血管钙化管理提供参考依据。
Objective To develop a prediction nomogram for the occurrence of abdominal aortic calcification(AAC)in patients on maintenance hemodialysis with arteriovenous fistula(AVF)using common clinical data.Methods A total of 175 maintenance hemodialysis patients from our hemodialysis centre from January 2019 to October 2022 were selected and divided into two groups(AAC group and non-AAC group)based on whether they had abdominal aortic calcification(AAC),and general information and relevant laboratory test information were collected from all patients to construct a prediction nomogram.Results A total of 175 patients were included,of which 140 were in the AAC group.The results of the comparative analysis of clinical characteristics between the two groups suggested that blood pressure,duration of dialysis maintenance,haemoglobin(Hb)and hematocrit(HCT)were higher in the AAC group than in the non-AAC group(p<0.05).A prediction nomogram for the occurrence of AAC was constructed based on Lasso regression analysis screening for age,suffering from diabetes,body mass index(BMI),diastolic blood pressure,duration of maintenance dialysis,Hb,parathyroid hormone(PTH),albumin(Alb),and total iron binding capacity(TIBC).The area under receiver operating characteristic curve(ROC)was 0.84[95%CI(0.76,0.89)],and the model precision was 0.96.The decision curve analysis(DCA)suggested that the model could increase the degree of patient benefit,and the calibration curve(CA)suggested that the model predicted results were in good agreement with the actual results.Conclusion In this study,a prediction nomogram for the occurrence of AAC in maintenance haemodialysis patients with AVF is constructed based on Lasso regression screening of predictor variables,which has good precision and discrimination and provides a reference basis for the management of vascular calcification in maintenance haemodialysis patients.
作者
任丽丽
郭宁
冯静静
杨惠敏
杨向东
REN Lili;GUO Ning;FENG Jingjing;YANG Huimin;YANG Xiangdong(Hemodialysis Center,Qilu Hospital of Shandong University,Jinan 250012,China;Department of Nephrology,Qihe County People′s Hospital,Dezhou 251100,Shandong,China)
出处
《西部医学》
2024年第2期222-227,共6页
Medical Journal of West China
基金
国家自然科学基金项目(82000692)。
关键词
血液透析
动静脉内瘘
腹主动脉硬化
预测模型
Hemodialysis
Arteriovenous fistula
Abdominal aortic calcification
Nomogram
作者简介
通讯作者:杨向东,主任医师,E-mail:yxd683@163.com。
