Logistic回归模型和决策树模型在急性胰腺炎复发分析中的应用研究  

Application of logistic regression model and decision tree model in the analysis of the recurrence of acute pancreatitis

作　　者：周惠敏 陈海艳 陆含笑 吴波 崔佳琪 张硕 顾元龙 杨军 Zhou Huimin;Chen Haiyan;Lu Hanxiao;Wu Bo;Cui Jiaqi;Zhang Shuo;Gu Yuanlong;Yang Jun(Wuxi Medical College of Jiangnan University,Wuxi 214000,China;Department of Hepatobiliary Surgery,Affiliated Hospital of Jiangnan University,Wuxi 214000,China)

机构地区：[1]江南大学无锡医学院,无锡214000 [2]江南大学附属医院肝胆外科,无锡214000

出　　处：《中华肝胆外科杂志》2023年第9期669-673,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：无锡市社会发展科技示范工程项目(N20201003);无锡市"双百"中青年医疗卫生拔尖人才培养计划(BJ2020045);无锡市转化医学研究所项目(LCYJ202218)。

摘　　要：目的评估logistic回归模型和卡方自动交互检测决策树模型预测急性胰腺炎复发的价值。方法回顾分析2021年6月至2022年6月在江南大学附属医院接受治疗的急性胰腺炎患者临床资料。共纳入364例患者,其中男性219例,女性145例,年龄范围19~91岁,中位年龄53岁。364例患者中急性胰腺炎独立发作2次及2次以上者纳入复发组(n=63),首次发作纳入首发组(n=301)。单因素和多因素logistic回归分析急性胰腺炎复发的影响因素,同时决策树模型分析急性胰腺炎复发的影响因素。绘制受试者工作特征(ROC)曲线分析两种模型对急性胰腺炎复发的预测效果。结果多因素logistic回归分析显示,年龄(OR=0.969,95%CI:0.949~0.990,P=0.004)、体质量指数(OR=1.142,95%CI:1.059~1.232,P=0.001)、伴高脂血症(OR=3.034,95%CI:1.543~5.964,P=0.001)是急性胰腺炎复发的独立影响因素。模型预测复发的准确率为83.2%(303/364)。决策树模型分析显示,伴高脂血症、体质量指数是急性胰腺炎复发的影响因素,模型预测复发的准确率为82.7%(301/364)。Logistic回归模型预测复发ROC曲线下面积大于决策树模型(0.776比0.730,Z=2.02,P=0.043)。结论Logistic回归模型及卡方自动交互检测决策树模型可以预测急性胰腺炎复发,建议将两种模型结合使用,更好地指导临床实践。Objective To study the logistic regression model and Chi-square automatic interaction detection decision tree model in the prediction of the recurrence of acute pancreatitis(AP).Methods Clinical data of 364 patients with AP admitted to the Affiliated Hospital of Jiangnan University from June 2021 to June 2022 were retrospectively analyzed,including 219 males and 145 females,aged 53(19-91)years.The patients were divided into the recurrence group(n=63),those who experienced a second or more episodes of AP,and the initial group(n=301),those who were diagnosed of AP for the first time.Univariate and multivariate logistic regression analyses were performed to identify the factors associated with recurrence of AP,and the decision tree model was used to analyze those factors.Receiver operating characteristic(ROC)curve were plotted to analyze the predictive performance of the two models.Results Multivariate logistic regression analysis showed that age(OR=0.969,95%CI:0.949-0.990,P=0.004),body mass index(OR=1.142,95%CI:1.059-1.232,P=0.001),and hyperlipidemia(OR=3.034,95%CI:1.543-5.964,P=0.001)were independent factors influencing the recurrence of AP.The accuracy of the model in predicting recurrence was 83.2%(303/364).The decision tree model showed that hyperlipidemia and body mass index were factors influencing the recurrence of AP,with an accuracy of 82.7%(301/364)in predicting recurrence.The area under the ROC curve was larger in the logistic regression model compared to that in the decision tree model(0.776 vs 0.730,Z=2.02,P=0.043).Conclusion The logistic regression model and the Chi-square automatic interaction detection decision tree model can help predict the recurrence of AP.It is recommended to combine the two models to better guide clinical practice.

关 键 词：胰腺炎 复发 影响因素 

分 类 号：R576[医药卫生—消化系统]