中老年女性下尿路症状相关因素分析及风险列线图模型的构建  

Analysis of factors associated with lower urinary tract symptoms in middle-aged and elderly women and the construction of a nomogram model for risk prediction

作　　者：刘纪实[1,2] 潘诗琪 李怡素 李楠楠 卢敏 雷雨萌 张开倩 贺雪[1] Liu Jishi;Pan Shiqi;LiYisu;Li Nannan;Lu Min;Lei Yumeng;Zhang Kaiqian;He Xuei(Health Management Center,the Third Xiangya Hospital of Central South University,Changsha 410013,China;Department of Nephrology and Rheumatology,the Third Xiangya Hospital of Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院健康管理中心,长沙410083 [2]中南大学湘雅三医院肾内与风湿免疫科,长沙410083

出　　处：《中华老年医学杂志》2022年第9期1081-1086,共6页Chinese Journal of Geriatrics

基　　金：国家自然科学基金(82070738);湖南省自然科学基金(2021JJ31015);湖南省卫生健康委基金(202103050563、202104022248)。

摘　　要：目的通过分析55~65岁中老年女性下尿路症状发生的相关影响因素, 构建该人群下尿路症状列线图模型, 协助临床制定针对性干预措施, 降低该人群下尿路症状的发生率。方法横断面研究, 以2013年11月至2020年12月于湘雅三医院健康管理中心进行体检的798例55~65岁的中老年女性为研究对象, 采用单因素分析比较该人群下尿路症状相关基础资料的差异, 采用多因素Logistic回归分析筛选相关影响因素, 并建立该人群下尿路症状列线图风险模型。结果在798例被调查的55~65岁中老年女性中, 下尿路症状患病率为81.08%(647例), 尿路感染占比21.48%(139例);将单因素分析中有统计学意义的变量纳入多因素Logistic回归分析, 结果显示, 体质指数、阴道分娩、盆底Ⅱ类纤维肌力、盆腹协调性、心理健康评分为55~65岁中老年女性下尿路症状发生的独立影响因素(OR=1.099、2.681、0.895、0.658、1.057, P=0.010、0.030、0.040、0.010、0.038);并利用这5个风险预测指标构建列线图模型, 其一致性指数(C-index)为0.651, 诊断灵敏度、特异度分别为66.9%、58.9%, 校正曲线显示模型预测效果与实际患病概率基本相同。结论本研究通过单因素、多因素分析筛选55~65岁中老年女性下尿路症状发生的独立影响因素, 并构建该人群列线图风险模型, 经验证该列线图模型具有较好的预测能力, 能准确、有效地预测55~65岁中老年女性下尿路症状发生的风险, 从而协助临床医师筛选高风险患者, 制定有针对性的干预措施, 降低55~65岁中老年女性下尿路症状的发生率。ObjectiveBy analyzing factors associated with lower urinary tract symptoms in middle-aged and elderly women aged 55-65 years old,a nomogram model for lower urinary tract symptoms was constructed to assist the clinical development of targeted interventions to reduce the incidence of lower urinary tract symptoms in this population.,Methods In the cross-sectional study.798 middle-aged and elderly women aged 55-65 years receiving physical examination in the Health Management Center of Third Xiangya Hospital from November 2013 to December 2020 were selected as research participants.Univariate regression analysis was used to compare differences in the basic data related to lower urinary tract symptoms in the population.Multivariate Logistic regression analysis was used to identify related influencing factors,and a nomogram model for lower urinary tract symptoms in the population was established.ResultsAmong 798 middle-aged and elderly women surveyed,the prevalence of lower urinary tract symptoms was 81.08%(647 cases),and the rate of urinary tract infections was 21.48%(139 cases).Variables with statistical significance in univariate regression analysis were included in multivariate Logistic regression analysis.The results showed that body mass index,vaginal delivery,strength of pelvic floor type IIl fiber muscle,pelvic and abdominal coordination and mental health were independent influencing factors for lower urinary tract symptoms in middle-aged and elderly women aged 55-65 years(OR=1.099,2.681,0.895,0.658,1.057,P=0.010,0.030,0.040,0.010,0.038).The monogram model based on the five risk prediction indexes produced a consistency index(C-index)of 0.651 and a diagnostic sensitivity and specificity of 66.9%and 58.9%,respectively.The correction curve showed that the predicted results of the model were essentially the same as the actual probability of conditionC.(onclusionsIn this study,the independent influencing factors for lower urinary tract symptoms in middle-aged and elderly women aged 55-65 years were screened by univa

关 键 词：下尿路症状 危险因素 列线图 

分 类 号：R691[医药卫生—泌尿科学]