摘要
目的建立及验证肾病综合征型子痫前期的模型,为妇产科医生早期识别和早期诊断肾病综合征型子痫前期提供参考。方法回顾性分析2012年1月至2021年1月在广西医科大学第一附属医院和广西医科大学附属武鸣医院住院并分娩的60名肾病综合征型子痫前期病例,并选取同期202例为非肾病综合征型子痫前期患者作为对照组。将病例按照7∶3比例随机分为训练集和验证集,训练集依据是否临床诊断肾病综合征型子痫前期进行分组,进行logistic单因素及多因素分析,建立肾病综合征型子痫前期的预测模型,对模型区分度、校准度进行检验,使用Bootstrap进行内部验证,并使用验证集数据进行内部验证。列线图实现模型可视化。结果Logistic单因素及多因素分析最终保留4个变量:是否早发型、初产妇、总蛋白、纤维蛋白原。建立诊断预测模型,使用列线图呈现。使用验证组内部验证ROC为0.9517,模型具有较好的推广性。内部验证的HL检验χ^(2)值为5376.1,P<0.001。结论构建的预测模型可作为临床医师诊断肾病综合征型子痫前期的参考依据。
Objective To establish and validate a model for predicting pre-eclampsia with nephrotic syndrome,providing reference for obstetricians to identify and diagnose pre-eclampsia with nephrotic syndrome early.Methods A retrospective analysis was conducted on 60 cases of pre-eclampsia with nephrotic syndrome hospitalized for delivery from January 2012 to January 2021 at the First Affiliated Hospital of Guangxi Medical University and Wuming Hospital affiliated to Guangxi Medical University.Additionally,202 cases of non-pre-eclampsia with nephrotic syndrome patients during the same period were selected as the control group.The cases were randomly divided into a training set and a validation set at a ratio of 7∶3.Logistic univariate and multivariate analyses were performed on the training set according to whether pre-eclampsia with nephrotic syndrome was clinically diagnosed to establish a prediction model.The discriminative ability and calibration of the model were tested,and internal validation was conducted using bootstrap and validation set data.The model was visualized using a column line chart.Results Logistic univariate and multivariate analysis ultimately retained 4 variables:early-onset type,primiparity,total protein,and fibrinogen.A diagnostic prediction model was established and presented using a column line chart.The internal validation area under the ROC curve was 0.9517,indicating good generalization of the model.The HL test statistic for internal validation was 5376.1,with P<0.001.Conclusion The constructed prediction model can serve as a reference for clinical physicians to diagnose pre-eclampsia with nephrotic syndrome.
作者
杨春颖
曾雅畅
YANG Chun-ying;ZENG Ya-chang(Department of Obstetrics,Wuming Hospital Affiliated to Guangxi Medical University,Nanning 530199,Guangxi,China)
出处
《广东医学》
CAS
2024年第7期801-806,共6页
Guangdong Medical Journal
基金
广西医疗卫生适宜技术开发与推广应用项目(S2022080)
2022年度广西壮族自治区卫生健康委西医类自筹经费科研课题(ZA20220782)。
关键词
肾病综合征
子痫前期
预测模型
nephrotic syndrome
preeclampsia
prediction model
