首页|原发性高血压患者并发左心室肥厚的预测模型构建与验证

原发性高血压患者并发左心室肥厚的预测模型构建与验证

Construction and validation of a prediction model for left ventricular hypertrophy in patients with essential hypertension

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目的 构建并验证原发性高血压患者并发左心室肥厚(left ventricular hypertrophy,LVH)的预测模型.方法 选取2022年1月至12月于武汉市中心医院心血管内科住院治疗的332例原发性高血压患者为研究对象,经K折交叉验证划分为训练集与验证集.在训练集中采用LASSO回归、单因素及多因素Logistic回归模型分析原发性高血压患者并发LVH的独立影响因素,将其整合到预测模型中.通过受试者工作特征曲线、Hosmer-Lemeshow检验、校准曲线及决策曲线分别在训练集与验证集中判断预测模型的区分度、校准度、适用度,并绘制列线图将预测模型的结果可视化呈现.结果 收缩压[OR=1.03,95%CI(1.01,1.05),P<0.001]为原发性高血压患者并发LVH的独立危险因素,而静息心率[OR=0.96,95%CI(0.93,0.98),P=0.002]、血清白蛋白[OR=0.90,95%CI(0.81,0.99),P=0.032]、血小板分布宽度[OR=0.36,95%CI(0.14,0.96),P=0.042]为原发性高血压并发LVH的保护因素.在训练集与验证集中,预测模型的区分度、校准度、适用度较好.结论 本研究构建并验证了原发性高血压患者并发LVH的预测模型,为LVH的风险预测提供了直观且简便的工具.
Objective To establish and validate a model for predicting left ventricular hypertrophy(LVH)in patients with essential hypertension.Methods 332 patients with essential hypertension who were hospitalized in the Department of Cardiovascular Medicine of The Central Hospital of Wuhan from January to December 2022 were selected as the study subjects,and they were divided into the training set and validation set by K-fold cross-validation.In the training set,independent influencing factors on LVH in patients with essential hypertension were analysed using LASSO regression,univariate and multivariate Logistic regression models,and then these factors were integrated into the prediction model.The discrimination,calibration and applicability of the prediction model were judged by the receiver operating characteristic curve,Hosmer-Lemeshow,calibration curve and decision curve in the training set and validation set.The Nomogram was drawn to visualize the results of the prediction model.Results Systolic blood pressure[OR=1.03,95%CI(1.01,1.05),P<0.001]was the independent risk factor of LVH in patients with essential hypertension.Resting heart rate[OR=0.96,95%CI(0.93,0.98),P=0.002],serum albumin[OR=0.90,95%CI(0.81,0.99),P=0.032],and platelet distribution width[OR=0.36,95%CI(0.14,0.96),P=0.042]were protective factors of LVH in patients with essential hypertension.The prediction model had good differentiation,calibration and applicability in the training and validation sets.Conclusion A prediction model for LVH in patients with essential hypertension was established and validated,which provided an intuitive and easy tool for the risk prediction of LVH.

Essential hypertensionLeft ventricular hypertrophyNomogramPrediction model

吴艳、艾芬

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江汉大学医学部(武汉 430056)

武汉市中心医院急诊科(武汉 430014)

原发性高血压 左心室肥厚 列线图 预测模型

2024

数理医药学杂志
武汉大学,中国工业与应用数学学会,医药数学专业委员会

数理医药学杂志

影响因子:0.479
ISSN:1004-4337
年,卷(期):2024.37(3)
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