中华普通外科学文献(电子版)2024,Vol.18Issue(4) :266-270.DOI:10.3877/cma.j.issn.1674-0793.2024.04.005

急性胰腺炎并发门静脉系统血栓形成的危险因素及预测模型构建

Risk factors and prediction model built for portal vein system thrombosis in patients with acute pancreatitis

李国煜 丛赟 祖丽胡马尔·麦麦提艾力 何铁英
中华普通外科学文献(电子版)2024,Vol.18Issue(4) :266-270.DOI:10.3877/cma.j.issn.1674-0793.2024.04.005

急性胰腺炎并发门静脉系统血栓形成的危险因素及预测模型构建

Risk factors and prediction model built for portal vein system thrombosis in patients with acute pancreatitis

李国煜 1丛赟 2祖丽胡马尔·麦麦提艾力 1何铁英1
扫码查看

作者信息

  • 1. 830011 乌鲁木齐,新疆医科大学第一附属医院胰腺外科
  • 2. 830011 乌鲁木齐,新疆医科大学第一附属医院肝胆包虫病外科
  • 折叠

摘要

目的 探讨急性胰腺炎患者并发门静脉系统血栓形成的危险因素并构建预测模型.方法 回顾性分析 2020 年 1 月至 2022 年 12 月在新疆医科大学第一附属医院接受治疗的 188 例急性胰腺炎患者临床资料,分为血栓组(46 例)和非血栓组(142 例).分析急性胰腺炎合并门静脉系统血栓的危险因素并构建预测模型,运用受试者工作特征(ROC)曲线、校准曲线、Hosmer-Lemeshow检验以及临床决策曲线进行评价.结果 门静脉系统血栓发生率为 24.47%(46/188).Logistic 回归分析结果显示,腹水(OR=2.28,95%CI:1.04~5.00,P=0.040)、白细胞计数≥10×109/L(OR=3.69,95%CI:1.55~8.78,P=0.003)、三酰甘油-葡萄糖指数≥9.21(OR=4.38,95%CI:1.90~10.11,P=0.001)是急性胰腺炎患者并发门静脉系统血栓的独立危险因素.将上述危险因素绘制ROC曲线,曲线下面积为 0.790.Hosmer-Lemeshow检验χ2=4.293,P=0.891,表明预测值和观测值之间没有完美拟合偏差.校准曲线的Brier值为 0.144,表示该模型在预测中的准确性较高,预测结果与实际观测值的差异相对较小.制作急性胰腺炎并发门静脉系统血栓的预测模型,根据得分实现初步预测.结论 腹水、白细胞计数≥10×109/L以及三酰甘油-葡萄糖指数≥9.21是急性胰腺炎并发门静脉系统血栓形成的独立危险因素,基于以上危险因素构建的列线图具有良好的区分度和准确性,可为治疗策略提供参考.

Abstract

Objective To investigate the risk factors for patients with acute pancreatitis(AP)combined with portal vein system thrombosis(PVST)and develop a predictive model.Methods A retrospective analysis was conducted in clinical data of patients undergoing treatment for pancreatitis at the First Affiliated Hospital of Xinjiang Medical University from January 2020 to December 2022.188 cases of AP were finally included based on the inclusion and exclusion criteria,with 46 cases in the thrombosis group and 142 cases in the non-thrombosis group.Clinical data of the two groups were compared to analyze the risk factors for PVST in patients with AP and develop a predictive model.Receiver operating characteristic curve(ROC),calibration curve,Hosmer-Lemeshow test,and clinical decision curve were used for evaluation.Results PVST occurred in 46(24.47%)of the 188 patients with AP.Multivariate Logistic regression analysis showed that ascites(OR=2.28,95%CI:1.04-5.00,P=0.040),white blood cell count 10×109/L(OR=3.69,95%CI:1.55-8.78,P=0.003),and TYG≥9.21(OR=4.38,95%CI:1.90-10.11,P=0.001)were independent risk factors for PVST in patients with AP.ROC curve analysis of these risk factors yielded an area under the curve of 0.790.The Hosmer-Lemeshow test showed χ2 value of 4.293 and P value of 0.891,indicating that there was no statistically significant lack of fit between the predicted values and observed values.The Brier score of the calibration curve was 0.144,indicating high accuracy of the model in prediction with small differences between the predicted and observed values.The created predictive model for PVST in patients with AP allowed for initial risk assessment based on the calculated scores.Conclusions Ascites,white blood cell count 10×109/L,and TYG≥9.21 are independent risk factors for the development of PVST in patients with AP.The constructed column chart based on these risk factors demonstrates good discriminatory power and accuracy,providing references for the treatment strategies for PVST with AP.

关键词

胰腺炎/静脉血栓栓塞/危险因素/预测模型

Key words

Pancreatitis/Venous thromboembolism/Risk factors/Predictive model

引用本文复制引用

出版年

2024
中华普通外科学文献(电子版)
中华医学会

中华普通外科学文献(电子版)

CSTPCD
影响因子:0.668
ISSN:1674-0793
段落导航相关论文