输尿管结石患者并发炎性息肉风险的列线图预测模型的构建  

Construction of a nomogram prediction model for risk factors of inflammatory polyps in patients with ureteral calculi

作　　者：任衢军 张刚[1] 成泽民[1] 杜义堂 黄超[1] 张波[1] 袁宗琳 REN Qujun;ZHANG Gang;CHENG Zemin;DU Yitang;HUANG Chao;ZHANG Bo;YUAN Zonglin(Department of Urology,Dazhou Central Hospital of Sichuan Province,Dazhou 635000,China)

机构地区：[1]四川省达州市中心医院泌尿外科,四川达州635000

出　　处：《现代泌尿外科杂志》2022年第10期859-863,共5页Journal of Modern Urology

摘　　要：目的 探讨输尿管结石患者并发炎性息肉的风险因素,并依此建立列线图预测模型。方法 回顾性分析四川省达州市中心医院2018年1月-2022年1月收治的329例输尿管结石患者的临床资料,根据临床检查结果将其分为并发息肉组(85例)和未并发息肉组(244例)。采用多因素logistic回归分析输尿管结石并发炎性息肉的风险因素并绘制列线图模型,列线图的预测效能和校准度分别用受试者工作特征(ROC)曲线评估和Bootstrap法检验。结果 病程、非球形结石、结石表面粗糙、尿路感染、炎性反应均是输尿管结石并发炎性息肉的危险因素(P<0.05);ROC曲线分析显示,根据多因素分析结果建立的列线图模型预测输尿管并发炎性息肉的曲线下面积(AUC)、灵敏度和特异度分别为0.845(95%CI:0.801~0.882)、75.29%、85.25%;经Bootstrap法进行内部验证,其一致性指数(C-index)为0.815。结论 基于风险因素构建的列线图预测模型效能较好,可为临床医师早期识别输尿管结石并发炎性息肉高风险患者提供参考。Objective To explore the risk factors of inflammatory polyps in patients with ureteral calculi, and to establish a nomogram prediction model.Methods The clinical data of 329 patients with ureteral calculi admitted to our hospital during Jan.2018 and Jan.2022 were retrospectively analyzed.According to the clinical examination results, the patients were divided into polyp group(n=85) and non-polyp group(n=244).Multivariate logistic regression was used to analyze the risk factors of inflammatory polyps and a nomogram model was plotted.The predictive efficacy and calibration of the nomogram were evaluated with receiver operating characteristic(ROC) curve and Bootstrap method, respectively.Results The course of disease, non-spherical calculi, rough stone surface, urinary tract infection and inflammatory reaction were risk factors of inflammatory polyps(P<0.05).The ROC curve showed that the area under the curve(AUC), sensitivity and specificity of the nomogram model were 0.845(95%CI:0.801-0.882), 75.29% and 85.25%, respectively.Internal verification with Bootstrap method showed the C-index was 0.815.Conclusions The nomogram prediction model based on risk factors has good efficacy, which can provide reference for clinicians to identify patients at high risk of ureteral calculi complicated with inflammatory polyps in early stage.

关 键 词：输尿管结石 炎性息肉 风险因素 列线图模型 预测价值 

分 类 号：R693.4[医药卫生—泌尿科学]