摘要
目的:建立并验证维持性血液透析患者疲乏风险预测模型.方法:采取便利抽样法选取进行维持性血液透析的217例患者,随机分为建模组173例与验证组44例.采用单因素Logistic回归分析筛选建模组的危险因素,多因素Logistic回归分析确定最终影响因素;利用R软件建立预测列线图模型;利用ROC曲线、校准曲线与Hosmer-Lemeshow检验及临床决策曲线分别评价模型的预测性能及临床适用性.结果:年龄、体质指数、婚姻状况、透析并发症个数、心理弹性、匹兹堡睡眠质量指数量表评分及血肌酐是维持性血液透析患者疲乏的影响因素;建模组与验证组的ROC曲线下面积分别为0.888(95％CI:0.831～0.945)与0.876(95％CI:0.775～0.977),2组校准曲线拟合度较好,分别为(x2=4.290,P=0.892与x2=10.900,P=0.283).结论:本研究构建的风险预测模型预测效果较好,可为临床医护人员早期识别维持性血液透析患者的疲乏风险、制定有效的干预措施提供参考.
Abstract
Objective: To establish and verificate a fatigue risk prediction model for maintenance hemodialysis patients. Methods: A convenient sampling method was used to select 217 patients who were undergoing maintenance hemodialysis. According to the 8:2 random separation method, they were randomly divided into the modeling group (173 cases) and the validation group (44 cases). Single factor Logistic regression analysis was used to screen the risk factors of the modeling group, and multi factor Logistic regression analysis was used to determine the final influencing factors; R software was used to build the nomogram model of prediction; the area under curve, calibration curve, Hosmer and lemeshow test were used to evaluate the predictive performance of the model. Results: Age, BMI, marital status, the number of dialysis complications, psychological resilience, PSQI score and serum creatinine were the influencing factors of fatigue in maintenance hemodialysis patients. The area under the ROC curve of the model-ing group and the validation group were 0.888 (95％CI:0.831～0.945) and 0.876 (95％CI:0.775～0.977), respectively. The fitting degree of the calibration curve of the two groups was good. The Hosmer and lemeshow test values were x2=4.290, P=0.892 and x2=10.900, P=0.283, respectively. Conclusion: The risk prediction model constructed in this study has a good prediction effect, and can provide reference for clinical medical staff to identify the fatigue risk of maintenance hemodialysis patients early and formulate effective intervention measures.
维普
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