北疆牧区高血压人群治疗不依从性风险的列线图  

A Nomogram of Nonadherence Risk in the Treatment of Hypertension Population in the Pastoral Area of Northern Xinjiang

作　　者：蔡昕添 朱晴[1] 吴婷[1] 洪静[1] 刘莎莎 李南方[1] Cai Xintian;Zhu Qing;Wu Ting(National Health Committee Key Laboratory of Hypertension Diagnosis and Treatment Research,Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院高血压诊疗研究中心、新疆高血压研究所、国家卫生健康委员会高血压诊疗研究重点实验室,乌鲁木齐830001

出　　处：《医学研究杂志》2020年第8期91-96,55,共7页Journal of Medical Research

基　　金：新疆维吾尔自治区重点研发计划项目(2017B03015)。

摘　　要：目的本研究通过分析北疆牧区高血压人群降压治疗不依从性的独立危险因素,旨在建立并验证个体化预测北疆牧区高血压人群降压治疗不依从性的列线图模型。方法纳入2013年6月~2014年2月在中国西北新疆牧区进行的一项横断面流行病学调查研究所获得的516例高血压患者作为研究对象,并将研究对象随机分为建模组与验证组。应用单因素及多因素Lottie回归分析建模组数据,分析北疆牧区高血压人群降压治疗不依从性的独立危险因素。应用R语言软件构建预测北疆牧区高血压人群降压治疗不依从性的列线图模型,并对该模型的预测性能进行内部验证。结果多因素Logistic回归分析显示,高血压病程、是否购买医疗保险、是否自备血压计、高血压相关并发症、家庭年收入与职业状态均为北疆牧区高血压人群降压治疗不依从性的独立危险因素(P<0.05)。对列线图模型进行验证,建模组中AUC值为0.775(95%CI:0.723~0.822);验证组中AUC值为0.743(95%CI:0.645〜0.810)。无论是建模组还是验证组的校准图均显示该预测模型具有良好准确度。结论本研究基于高血压病程、是否购买医疗保险、是否自备血压计、高血压相关并发症、家庭年收入与职业状态这6项北疆牧区高血压患者治疗不依从性的独立影响因素,构建了预测北疆牧区高血压患者治疗不依从性风险的列线图模型。该模型具有良好的区分度与校准度,能个体化地实现对北疆牧区高血压患者治疗不依从性风险的预测,可指导临床筛选高风险的患者,应用价值较高。Objective To develop and internally validate a medication nonadherence risk nomogram in North Xinjiang pastoral area of patients with hypertension.Methods From June 2013 to February 2014,516 hypertensive patients were included in a cross-sectional epidemiological survey conducted in Xinjiang pastoral area of Northwest China.The subjects were randomly divided into modeling group and validation group.Univariate and multivariate logistic regression analysis was used to analyze the independent risk factors of the nonad.herence of hypotensive treatment in hypertensive population in North Xinjiang pastoral area.The R software was used to construct a nomogram model to predict the nonadherence of antihypertensive treatment in hypertensive population in North Xinjiang pastoral area,and the prediction performance of the model was verified internally.Results Multivariate logistic regression analysis showed that the course of hypertension,whether to purchase medical insurance,whether to have a sphygmomanometer,hypertension-related complications,annual family income and occupational status were all independent risk factors for the nonadherence of hypertension treatment in people in North Xinjiang pastoral area(P<0.05).The AUC value in the modeling group was 0.775(95%CI:0.723-0.822),and the AUC value in the validation group was 0.743(95%CI:0.645-0.810).The calibration plot of both the modeling group and the validation group show that the prediction model has good accuracy.Conclusion Based on the independent influencing factors such as the course of hypertension,whether to purchase medical insurance,whether to have a sphygmomanometer,hypertension related complications,family annual income and occupational status,this study constructed a nomogram model to predict the risk of treatment nonadherence of hypertension patients in North Xinjiang pastoral area.The model has a good degree of differentiation and calibration,which can realize the individualized prediction of the risk of treatment non-compliance of hypertension patients in

关 键 词：北疆牧区 高血压 不依从性 列线图 

分 类 号：R544.1[医药卫生—心血管疾病]