高度近视继发脉络膜病变的相关因素Logistic回归分析及风险模型构建  

Logistic regression analysis and risk model construction of choroidopathy secondary to high myopia

作　　者：黄晓寒 唐少华 HUANG Xiaohan;TANG Shaohua(Department of Ophthalmology,Beijing Jishuitan Hospital,Capital Medical University,Beijing 102202,China)

机构地区：[1]首都医科大学附属北京积水潭医院眼科,北京市102202

出　　处：《眼科新进展》2024年第1期52-57,共6页Recent Advances in Ophthalmology

摘　　要：目的基于Logistic回归分析高度近视继发脉络膜病变(脉络膜萎缩及脉络膜新生血管病灶)的影响因素,并根据相关因素构建Nomogram风险预测模型,可为临床治疗提供指导。方法选取2021年1月至2023年1月北京积水潭医院收治的340例(680眼)高度近视患者为研究对象,随机分为A组(170例340眼)、B组(170例340眼)。比较两组患者脉络膜病变发生率,在A组、B组中,根据是否发生脉络膜病变分为a组、b组两个亚组,多因素Logistic回归分析高度近视继发脉络膜病变的影响因素。根据影响因素构建高度近视继发脉络膜病变的Nomogram风险预测模型并进行外部验证。结果在A组、B组中,a组患者年龄、糖尿病占比、眼轴长度、血清转化生长因子-β1(TGF-β1)水平均高于b组,屈光度均低于b组(均为P<0.05)。Logistic回归分析结果显示,年龄、糖尿病、眼轴长度、血清TGF-β1水平为高度近视继发脉络膜病变的独立危险因素,屈光度为其保护因素(均为P<0.05)。年龄、糖尿病、眼轴长度、血清TGF-β1水平均为高度近视继发脉络膜病变正相关危险因素,屈光度为其负相关危险因素(均为P<0.05)。Nomogram风险预测模型预测高度近视继发脉络膜病变的AUC为0.818,且校准度良好。结论年龄、糖尿病、眼轴长度、屈光度、血清TGF-β1水平为高度近视继发脉络膜病变的影响因素,据此构建的Nomogram风险预测模型对高度近视继发脉络膜病变具有一定预测价值,临床应依据该模型制定治疗方案,以降低继发脉络膜病变发生风险。Objective To analyze the influencing factors of choroidopathy(choroidal atrophy and choroidal neovascularization)secondary to high myopia based on Logistic regression analysis and to construct a Nomogram risk prediction model based on the related factors,so as to provide guidance for clinical treatment.Methods A total of 340 patients(680 eyes)with high myopia admitted to Beijing Jishuitan Hospital from January 2021 to January 2023 were selected and divided into group A(170 patients,340 eyes)and group B(170 patients,340 eyes).The incidence of choroidopathy in the two groups was compared.The groups A and B were divided into two subgroups,subgroup a and subgroup b,according to whether choroidopathy occurred or not.Multivariate Logistic regression analysis was carried out to explore the influencing factors of choroidopathy secondary to high myopia.A Nomogram risk prediction model for choroidopathy secondary to high myopia was constructed based on the influencing factors and externally validated.Results In groups A and B,the age,proportion of diabetes mellitus,axial length,and level of serum transforming growth factorβ1(TGF-β1)of patients in subgroup a were higher than those in the subgroup b,and the diopter was lower than that in the subgroup b(all P<0.05).The Logistic regression analysis showed that age,diabetes mellitus,axial length and serum TGF-β1 level were independent risk factors for choroidopathy secondary to high myopia,and diopter was a protective factor(all P<0.05).Age,diabetes mellitus,axial length and serum TGF-β1 level were positively correlated risk factors for choroidopathy secondary to high myopia,and diopter was a negatively correlated risk factor(all P<0.05).The area under the curve of the Nomogram risk prediction model for predicting choroidopathy secondary to high myopia was 0.818,and the calibration was good.Conclusion Age,diabetes mellitus,axial length,diopter and serum TGF-β1 level are the influential factors for choroidopathy secondary to high myopia.The Nomogram risk prediction model es

关 键 词：高度近视 脉络膜萎缩 脉络膜新生血管病灶 Logistic回归 Nomogram模型 转化生长因子-Β1 

分 类 号：R778[医药卫生—眼科]