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肝硬化病人睡眠障碍列线图预测模型的构建与验证

Construction and validation of sleep disorder Nomogram prediction model in patients with liver cirrhosis

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【作者】 陆雅维张会许静仲蕾项晓婷

【Author】 LU Yawei;ZHANG Hui;XU Jing;ZHONG Lei;XIANG Xiaoting;School of Nursing, Anhui Medical University;The First Affiliated Hospital of Anhui Medical University;Anhui Public Health Clinical Center;

【通讯作者】 张会;

【机构】 安徽医科大学护理学院安徽医科大学第一附属医院安徽省公共卫生临床中心

【摘要】 目的:探讨肝硬化病人睡眠障碍的危险因素,构建肝硬化病人睡眠障碍风险预测模型,为临床医护人员提供有效、便捷的睡眠障碍筛查工具。方法:选取安徽省某三级甲等医院肝病科2023年3月—9月收治的肝硬化病人300例,采用Logistic回归分析探讨肝硬化病人睡眠障碍的影响因素,构建肝硬化病人睡眠障碍列线图风险预测模型,采用受试者工作特征(ROC)曲线、Hosmer-Lemeshow检验、校正曲线、决策曲线(DCA)评价模型的性能。结果:Logistic回归分析显示,营养、疼痛、抑郁、C反应蛋白、球蛋白是肝硬化病人睡眠障碍的影响因素。列线图模型的ROC曲线下面积(AUC)为0.773[95%C(I0.720,0.826)]。Hosmer-Lemeshow拟合优度检验(χ2=1.443,P=0.486)及校准曲线表明预测概率与观测概率具有较高一致性;DCA曲线表明使用该模型能够获得净收益。结论:营养、疼痛、抑郁、C反应蛋白、球蛋白是肝硬化病人睡眠障碍的影响因素,基于上述变量构建的列线图风险预测模型具有良好的预测效能,可作为临床早期预测肝硬化病人睡眠障碍风险的工具。

【Abstract】 Objective:To investigate the risk factors of sleep disorders in patients with liver cirrhosis,and construct a risk prediction model of sleep disorders in patients with liver cirrhosis, and provide an effective and convenient sleep disorder screening tool for clinical staff.Methods:A total of 300 patients with cirrhosis admitted to the department of hepatology of a tertiary grade A hospital in Anhui province from March 2023 to September 2023 were selected. Logistic regression analysis was used to explore the influencing factors of sleep disorders in patients with cirrhosis, and the risk prediction model of sleep disorders in patients with cirrhosis was constructed. Receiver operating characteristic( ROC) curve, Hosmer-Lemeshow test, correction curve and DCA were used to evaluate the performance of the model.Results:Logistic regression analysis showed that malnutrition, pain, depression, C-reactive protein and globulin were the influencing factors of sleep disorders in patients with cirrhosis. The area under ROC curve( AUC) of the model was 0. 773(95%CI 0. 720-0. 826).H-L goodness of fit test( χ2 =1. 443, P=0. 486) and calibration curve showed that the prediction probability and observation probability had high consistency. The DCA curve showed that the net benefit can be obtained by using the model. Conclusion:Nutrition,pain, depression, C-reactive protein and globulin are the influencing factors of sleep disorders in patients with cirrhosis. The risk prediction model based on the above variables has good predictive efficacy, and can be used as a tool for early clinical prediction of sleep disorders in patients with cirrhosis.

【基金】 2024年度安徽医科大学护理学院研究生青苗培育项目,编号:hlqm12024071
  • 【文献出处】 护理研究 ,Chinese Nursing Research , 编辑部邮箱 ,2025年05期
  • 【分类号】R473.5
  • 【下载频次】542
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