近视患者出现视网膜脱离的危险因素分析及列线图模型构建  

Analysis of risk factors for retinal detachment in myopic patients and construction of Nomogram prediction model

作　　者：王婵娟 李小璐 穆涛 张少弛 王辉[1] 毕小军[1] Wang Chanjuan;Li Xiaolu;Mu Tao;Zhang Shaochi;Wang Hui;Bi Xiaojun(People's Hospital of Ningxia Hui Autonomous Region(Ningxia Eye Hospital)/The First Affiliated Hospital of Northwest University for Nationalities/Ningxia Clinical Medical Research Center for Blinding Eye Diseases,Yinchuan 750000,China)

机构地区：[1]宁夏回族自治区人民医院(宁夏眼科医院)、西北民族大学第一附属医院、宁夏致盲性眼病临床医学研究中心,银川750000

出　　处：《中华眼底病杂志》2023年第8期669-674,共6页Chinese Journal of Ocular Fundus Diseases

基　　金：西北民族大学2020年中央高校创新团队项目(31920200027)。

摘　　要：目的分析近视患者出现视网膜脱离的相关危险因素,建立预测列线图模型并验证。方法横断面临床研究。2020年1月至2021年11月于宁夏回族自治区人民医院眼科检查确诊的近视合并视网膜脱离患者90例90只眼(观察组)纳入研究。选取同期因近视行眼科检查且年龄、性别匹配的近视人群90名90只眼作为对照组。分析两组受检者的临床资料,将有差异的指标进行单因素和多因素logistic回归分析,利用R软件可视化回归分析结果得到列线图,受试者工作特征曲线(ROC曲线)验证列线图的准确性;内部数据验证列线图模型的临床效能。结果与对照组比较,观察组患者年龄较大、近视屈光度较高,视疲劳、眼外伤、白内障者较多,脉络膜、视网膜厚度较低,有眼科手术史者较多,差异有统计学意义(P<0.05)。年龄、近视屈光度、视网膜厚度、脉络膜厚度的ROC曲线下面积(AUC)分别为0.612、0.613、0.720、0.704;最佳截断值为43岁、-3.5D、225μm、144μm。年龄(>43岁)、近视屈光度(>-3.5D)、视疲劳(有)、眼外伤(有)、白内障(有)、视网膜厚度(≤225μm)、脉络膜厚度(≤144μm)是影响近视患者出现视网膜脱离的危险因素(P<0.05)。列线图模型预测近视患者出现视网膜脱离风险的-致性指数为0.731(95%可信区间0.665~0.824);预测患者出现视网膜脱离的风险阈值>0.07。结论年龄>43岁、近视屈光度>-3.5D,有视疲劳、眼外伤、白内障,视网膜厚度≤225μm、脉络膜厚度≤144μm为影响近视患者出现视网膜脱离的危险因素;依据危险因素构建的列线图模型具有良好的准确性。Objective To analyze the risk factors associated with retinal detachment in patients with myopia,and to establish and validate the predictive column-line diagram model.Methods A cross-sectional clinical study.From January 2020 to November 2021,90 patients with myopia combined with retinal detachment who were diagnosed by ophthalmologic examination in the People's Hospital of Ningxia Hui Autonomous Region were included in the study(observation group).Ninety myopic patients with age-and gender-matched myopia who underwent ophthalmologic examination for myopia during the same period were selected as the control group.The clinical data of the two groups were analyzed,and the indicators with differences were subjected to univariate and multivariate logistic regression analyses.The results of the regression analyses were visualized by using R software to obtain the column charts,and the accuracy of the column charts was verified by the ROC curves of the subjects'work characteristics;the clinical efficacy of the column chart model was verified by the internal data.Results Compared with the control group,patients in the observation group were older,had higher myopic refraction,had more visual fatigue,ocular trauma,and cataracts,had lower choroidal and retinal thickness,and had more history of ophthalmic surgery,and the differences were statistically significant(P<0.05).The area under the ROC curve(AUC)for age,myopic refraction,retinal thickness,and choroidal thickness were 0.612,0.613,0.720,and 0.704,respectively;the optimal cutoff values were 43 years old,-3.5 D,225μm,and 144μm.the ROC values were 0.612,0.613,0.720,and 0.704 for age(>43 years old),myopic refraction(>-3.5 D),visual fatigue(yes),ocular trauma(yes),cataracts(yes),retinal thickness(≤225μm),and choroidal thickness(≤144μm)were the risk factors affecting the development of retinal detachment in myopic patients(P<0.05).The consistency index of the column chart model for predicting the risk of retinal detachment in patients with myopia was 0.731(95%confi

关 键 词：近视 视网膜脱离 危险因素 列线图模型 

分 类 号：R778.11[医药卫生—眼科]