腹膜透析患者抑郁的影响因素分析及列线图预测模型构建
Influencing factors and nomogram prediction model for depression in peritoneal dialysis patients
鲁冰 1任东升 1王建刚 1石新慧 1谷裕 1徐光 1马媛媛1
作者信息
- 1. 473000 河南南阳,南阳市中心医院
- 折叠
摘要
目的 探究导致腹膜透析患者抑郁发生的影响因素,构建列线图预测模型.方法 选取进行腹膜透析治疗的120例慢性肾脏病患者,根据抑郁筛查量表(PHQ-9),将研究对象分为抑郁组(PHQ-9≥5分,n=48)和对照组(PHQ-9＜5分,n=72).采用Logistic回归分析腹膜透析患者发生抑郁的独立危险因素并用R软件绘制列线图预测模型,用ROC曲线评估模型表现,采用校正及决策曲线检验模型预测性能.结果 与对照组比较,抑郁组透析病程较长、营养状况较差、家庭人均月收入较低、PSQI评分较高、hs-CRP及β2微球蛋白水平较高(P＜0.05).对连续性变量hs-CRP、β2微球蛋白进行ROC曲线分析,AUC分别为0.832、0.831,敏感度分别为64.58％、62.50％,特异度均为94.44％.回归结果显示,透析病程、家庭人均月收入、营养状况、PSQI评分、hs-CRP及β2微球蛋白为腹膜透析患者发生抑郁的危险因素(P＜0.05).将上述因素纳入列线图预测模型,AUC为0.845(95％CI:0.807～0.884),风险阈值＞0.05.结论 以透析病程、家庭人均月收入、营养状况、PSQI评分、hs-CRP及β2微球蛋白为危险因素建立列线图预测模型,能够有效预测腹膜透析患者抑郁的发生.
Abstract
Objective To explore the influencing factors of depression in peritoneal dialysis patients and construct a nomogram prediction model.Methods 120 patients with chronic kidney disease who underwent peritoneal dialysis treatment were selected and divided into depressed group(PHQ-9 score ≥5,n=48)and control group(PHQ-9 score＜5,n=72)based on Patient Health Questionnaire-9(PHQ-9).Independent risk factors for depression in peritoneal dialysis patients were analyzed through logistic regression and nomogram prediction model was plotted using R software.The model performance was assessed using ROC curve,and the predictive performance of the model was tested through calibration and decision curves.Results The depressed group showed longer dialysis duration,poorer nutritional condition,lower per capita monthly household income,higher PSQI score and higher levels of hs-CRP and β2-microglobulin than control group(P＜0.05).The AUCs of hs-CRP and β2-microglobulin were 0.832 and 0.831,with the sensitivities of 64.58％and 62.50％respectively,and specificity of 94.44％.Logistic regression results showed that the duration of dialysis,per capita monthly household income,nutritional condition,PSQI score,hs-CRP and β2-microglobulin were risk factors for depression in peritoneal dialysis patients(P＜0.05).Incorporating the above factors into the nomogram prediction model,the AUC was 0.845(95％CI:0.807～0.884),with the risk threshold＞0.05.Conclusion A nomogram prediction model with dialysis duration,per capita monthly household income,nutritional condition,PSQI score,hs-CRP and β2-microglobulin as risk factors is able to effectively predict the occurrence of depression in peritoneal dialysis patients.
关键词
腹膜透析/抑郁/列线图预测模型/终末期肾脏病Key words
Peritoneal dialysis/Depression/Nomogram prediction model/End-stage renal disease引用本文复制引用
基金项目
河南省医学科技攻关计划(联合共建)项目(LHGJ20191458)
南阳市科技攻关计划项目(KJGG144)
出版年
2024
NETL
NSTL
万方数据