中老年女性肾阳虚型压力性尿失禁风险预测模型的构建  

Construction on risk prediction model of stress urinary incontinence with kidney-yang deficiency for middle-aged and elderly women

作　　者：张晓兰[1] 方桂珍[5] 杨丹华[5] 吴悦[2] 高燕飞[3] 许敏霞 Zhang Xiaolan;Fang Guizhen;Yang Danhua;Wu Yue;Gao Yanfei;Xu Minxia(Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou Zhejiang 310006, China;People’s Hospital of Songyang County, Lishui Zhejiang 323400, China;Tongde Hospital of Zhejiang Province, Hangzhou Zhejiang 310012, China;Zhejiang Red Cross Hospital, Hangzhou Zhejiang 310005, China)

机构地区：[1]浙江省中医院临床护理学教研室,浙江杭州310006 [2]丽水市松阳县人民医院,浙江丽水323400 [3]浙江省立同德医院,浙江杭州310012 [4]浙江省红十字会医院,浙江杭州310005 [5]浙江省中医院,浙江杭州310006

出　　处：《护理与康复》2022年第7期1-5,共5页Journal of Nursing and Rehabilitation

基　　金：浙江省中医药科技计划项目,编号2021ZB119;浙江省中医药科技计划项目,编号2020ZA034。

摘　　要：目的 构建中老年女性肾阳虚型压力性尿失禁风险预测模型,并进行模型的验证及预测效能评价。方法 将在浙江省4家医院门诊及住院部收集的525例病例按照2∶1的比例分为建模样本和验证样本。采用多因素Logistic回归构建压力性尿失禁风险预测模型。采用Hosmer-Lemeshow和受试者工作特征曲线分别检验风险预测模型的区分度及一致性,对175例样本进行模型的外部验证。结果 中老年女性肾阳虚型压力性尿失禁发生率25.7%;最终进入模型的变量有文化程度、家庭年收入、便秘、慢性呼吸系统疾病、糖尿病、妊娠次数,Hosmer-Lemeshow检验模型拟合优度P=0.544,说明模型拟合效果较好;受试者工作特征曲线下面积为0.835,约登指数最大值为0.553,最佳截断点为0.282,敏感度为0.722,特异度为0.831。模型外部验证判断总正确率为81.1%。结论 中老年女性肾阳虚型压力性尿失禁风险预测模型具有一定的预测效能,可为筛查高风险人群提供借鉴。Objective To construct the risk prediction model of stress urinary incontinence with kidney-yang deficiency for middle-aged and elderly women,validate the model and evaluate the prediction efficiency.Method Divide 525 cases of patients from outpatient and inpatient departments of 4 hospitals in Zhejiang Province into modeling samples and validation samples according to the ratio of 2∶1.Use multivariate Logistic regression to construct the risk model of stress urinary incontinence.Use Hosmer-Lemeshow and receiver operating characteristic curve(ROC curve)to test the discrimination and consistency of the risk prediction model.Verify 175 samples of model externally.Result The incidence of stress urinary incontinence with kidney-yang deficiency for middle-aged and elderly women is 25.7%.The variables enter into the model finally are educational level,family income,constipation,chronic respiratory diseases,diabetes and times of pregnancy.The fitting effect tested by Hosmer-Lemeshow is P=0.544,indicating a good fitting effect of the model.The area under ROC curve is 0.835.The maximum value of Jordan index is 0.553.The best truncation point is 0.282.The sensitivity is 0.722.The specificity is 0.831.The overall accuracy of external verification of the model is 81.1%.Conclusion The risk prediction model of stress urinary incontinence with kidney-yang deficiency for middle-aged and elderly women has a certain prediction efficiency,which can provide reference for screening high-risk population.

关 键 词：压力性尿失禁 肾阳虚 风险预测 影响因素 模型构建 

分 类 号：R694+.54[医药卫生—泌尿科学]