[1]俞美艳,刘瑶,赵雅宁,等.中老年人高同型半胱氨酸血症风险列线图预测模型的构建与验证[J].军事护理,2023,40(11):27-31,35.[doi:10.3969/j.issn.2097-1826.2023.11.007]
　YU Meiyan,LIU Yao,ZHAO Yaning,et al.Construction of a Nomogram Risk Prediction Model for Hyperhomocysteinemia Among the Middle-Aged and Elderly and Its Validation Test[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(11):27-31,35.[doi:10.3969/j.issn.2097-1826.2023.11.007]
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中老年人高同型半胱氨酸血症风险列线图预测模型的构建与验证
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《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
40
期数:
2023年11期
页码:
27-31,35
栏目:
论著
出版日期:
2023-11-15

文章信息/Info

Title:
Construction of a Nomogram Risk Prediction Model for Hyperhomocysteinemia Among the Middle-Aged and Elderly and Its Validation Test
文章编号:
2097-1826(2023)11-0027-06
作者:
俞美艳; 刘瑶; 赵雅宁; 韩影; 赵大业; 张盼
(华北理工大学 护理与康复学院,河北 唐山 063210)
Author(s):
YU Meiyan; LIU Yao; ZHAO Yaning; HAN Ying; ZHAO Dayei; ZHANG Pan
(School of Nursing and Rehabilitation,North China University of Science and Technology,Tangshan 063210,Hebei Province,China)
关键词:
高同型半胱氨酸血症;  中老年;  危险因素;  列线图;  预测模型
Keywords:
hyperhomocysteinemia;  middle-aged and elderly people;  risk factor;  nomogram;  prediction model
分类号:
R473.59
DOI:
10.3969/j.issn.2097-1826.2023.11.007
文献标志码:
A
摘要:
目的 探讨中老年人发生高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)的危险因素并构建列线图风险预测模型。方法 便利抽样法选取唐山市某三级甲等综合医院体检健康管理中心进行健康体检的1180例中老年人为研究对象,按照7:3的比例划分为训练集(n=826)和验证集(n=354)。根据是否发生HHcy将训练集的中老年人分为病例组(n=376)和对照组(n=450)。通过单因素和多因素Logistic回归分析筛选中老年发生HHcy的独立危险因素并构建列线图预测模型。采用受试者工作特征曲线、校准曲线和决策曲线来评估模型的预测效能。结果 年龄、性别、吸烟、饮酒、心理状态、体质量指数、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和尿酸为中老年发生HHcy的独立危险因素(均P<0.05)。构建的预测模型曲线下面积为0.860(95%CI=0.836～0.884),Hosmer-Lemeshow检验χ2=11.228(P=0.189),一致性指数为0.860。外部验证结果显示曲线下面积为0.849(95%CI=0.810～0.888),Hosmer-Lemeshow检验χ2=10.109(P=0.258),一致性指数为 0.863。临床决策曲线的阈值概率在0.01～0.92时,临床净受益较高。结论 构建的中老年人HHcy风险预测模型有较好的预测效率和临床适用性,有助于医护人员筛查高风险人群,并据此制订个性化的预防措施。
Abstract:
Objective To explore the risk factors of hyperhomocysteinemia(HHcy)among middle-aged and elderly people,and construct a nomogram risk prediction model.Methods Convenient sampling was used to select 1180 middle-aged and elderly citizens who underwent physical examination in the center of physical examination and health management of a tertiary A hospital in Tangshan City.The participants were divided into the training set(n=826)and the validation set(n=354)at a ratio of 7:3.The participants in the training set were then divided into the case group(n=376)and the control group(n=450)according to the occurrence of HHcy.Univariate analysis and multivariate logistic regression analysis were used to screen the independent risk factors of HHcy among middle-aged and elderly people,and construct the nomogram risk prediction model.The receiver operating characteristic curve,calibration curve and decision curve were adopted to evaluate the prediction efficiency of the model.Results Age,gender,smoking,drinking,psychological status,body mass index,total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol and uric acid were independent risk factors of HHcy among the middle-aged and elderly(all P<0.05).The area under curve of the prediction model was 0.860(95%CI=0.836-0.884),the Hosmer-Lemeshow test χ2 was 11.228(P=0.189),and the concordance index was 0.860.The external validation showed the area under curve was 0.849(95%CI=0.810-0.888),the Hosmer-Lemeshow test χ2 was 10.109(P=0.258),and the concordance index was 0.863.When the threshold probability of clinical decision curve was from 0.01 to 0.92,the clinical net benefit was higher.Conclusions The HHcy risk prediction model for the middle-aged and elderly has good prediction efficiency and clinical applicability,which is helpful for medical staff to screen high-risk groups and formulate individualized prevention measures accordingly.

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备注/Memo

备注/Memo:
【收稿日期】2022-07-31 【修回日期】2023-06-14
【基金项目】唐山市科技创新团队培养计划(18130218A)
【作者简介】俞美艳,硕士在读,电话:0315-8805720
【通信作者】赵雅宁,电话:0315-8805720
更新日期/Last Update: 2023-11-15