预测肾脏血管平滑肌脂肪瘤自发性破裂出血风险列线图模型的建立与评价
A nomogram model for predicting spontaneous rupture and bleeding of renal angio-myolipoma
侯亚坤 1周星宇 1高钰 1宋鸿文 1刘强 1王玉杰 1王文光1
作者信息
- 1. 新疆医科大学第一附属医院泌尿外科,新疆乌鲁木齐 830054
- 折叠
摘要
目的 建立并评价预测肾脏血管平滑肌脂肪瘤(RAML)自发性破裂出血的风险模型,帮助临床更好地评估患者疫情与应对风险.方法 回顾性分析新疆医科大学第一附属医院泌尿外科 2018 年 1 月-2022 年 12 月诊断为 RAML 的 436 例患者资料,根据纳入排除标准最终有 216 例患者被纳入研究,根据是否破裂出血分为非破裂出血组(181 例)和破裂出血组(35 例).采用单因素和多因素分析影响 RAML自发性破裂出血的影响因素并根据 R语言建立列线图模型,使用 Calibration曲线和受试者工作特征曲线(ROC)线下面积(AUC)对模型进行评价.结果 研究发现临床表现、肿瘤直径、肿瘤外凸率、肿瘤血供、是否合并结节性硬化症(TSC)与破裂出血显著相关(P<0.05),建立的列线图 Calibration曲线拟合度较好,AUC线下面积为 0.956(95%CI:0.856～0.943),表明该模型具有良好的判别力.结论 本研究建立的列线图模型可以帮助临床较好地预测 RAML 自发性破裂出血的风险.
Abstract
Objective To establish a risk model for predicting spontaneous rupture bleeding of renal angiomyolipoma(RAML)in order to better assess and deal with the risk.Methods The information of 436 RAML patients diagnosed during Jan.2018 and Dec.2022 was retrospectively analyzed.According to the inclusion and exclusion criteria,216 patients were included and divided into the rupture bleeding group(n = 35)and non-rupture bleeding group(n = 181).The factors influencing spontaneous rupture bleeding were identified using univariate and multivariate analysis,and a nomogram was constructed accordingly with R language.The nomogram was evaluated using Calibration curve and area under the receiver operator characteristic curve(AUC).Results It was found that clinical manifestations,tumor diameter,tumor convexity,tumor blood supply,and tuberous sclerosis complex(TSC)were significantly correlated with rupture bleeding.The Calibration curve fitted well with the nomogram.The AUC was 0.956(95%CI:0.856-0.943),indicating that the nomogram had good statistical performance.Conclusion The model can effectively predict the risk of spontaneous rupture bleeding of renal an-giomyolipoma.
关键词
肾血管平滑肌脂肪瘤/自发性破裂出血/列线图/风险模型/肾功能损伤Key words
renal angiomyolipoma/spontaneous rupture bleeding/nomogram/risk model/renal impairment引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据