基于炎症标志物和临床特征特发性突发性感音神经性耳聋预后模型构建  

A nomogram construction of predicting prognosis of idiopathic sudden sensorineural hearing loss based on laboratory parameters and clinical features

作　　者：杨庆军[1] 宋玉美 赵春杰 宋纪军 YANG Qing-jun;SONG Yu-mei;ZHAO Chun-jie;SONG Ji-jun(Department of Otolaryngology,Zhoukou Central Hospital,Zhoukou,Henan 466000,China;Laboratory Department of Specialized Disease Hospital of Zhoukou Center for Disease Control and Prevention,Zhoukou,Henan 466000,China)

机构地区：[1]周口市中心医院耳鼻咽喉科,河南周口466000 [2]周口市疾病预防控制中心专科病医院检验科,河南周口466000

出　　处：《医药论坛杂志》2023年第24期18-23,共6页Journal of Medical Forum

摘　　要：目的基于特发性突发性感音神经性耳聋(idiopathic sudden sensorineural hearing loss,ISSNHL)的炎症指标和临床特征建立一个ISSNHL预后模型,为临床治疗提供参考。方法通过回顾性收集2014年1月至2022年12月周口市中心医院收治的432例ISSNHL患者,并通过电子病历系统收集患者的临床资料。将患者按照7∶3的比例随机分成训练集(n=307)和验证集(n=125)。训练集用于ISSNHL预后模型列线图的构建,而验证集用于验证ISSNHL预后模型列线图的临床可重复性。采用t检验,卡方检验和Fisher’s精确概率法对变量进行筛选。采用逐步logistic回归构建ISSNHL预后模型。随后,使用R软件构建ISSNHL预后模型列线图。采用曲线下面积评估列线图模型预测ISSNHL预后中的效能。采用校准曲线分析和决策曲线分析评价列线图模型的临床适用性。结果本研究构建的ISSNHL预后列线图模型包括基于这5个变量,分别为年龄,发病时间,眩晕,NLR,MHR和CAR。本列线图在训练集(AUC:0.945,敏感性:90.2%,特异性:87.0%)和内部验证集(AUC:0.927,敏感性:91.7%,特异性:90.0%)均展现出良好的预测价值。此外,决策曲线和校准曲线均证明了本预测模型的临床有效性。结论本研究所构建的列线图可有效地预测ISSNHL患者的预后,促进临床决策。Objective To establish a prognostic model nomogram for idiopathic sudden sensorineural hearing loss(ISSNHL)based on inflammatory indicators and clinical features,in order to provide reference for clinical treatment.Methods A total 432 SSNHL patients admitted to Zhoukou Central Hospital from January 2014 to December 2022 were retrospectively collected,and their clinical data were collected through an electronic medical record system.Randomly divide patients into a training set(n=307)and a validation set(n=125)in a 7∶3 ratio.The training set is used to construct the ISSNHL prognostic model nomogram,while the validation set is used to verify the clinical repeatability of the ISSNHL prognostic model nomogram.Variables were screened using t-tests,chi square tests,and Fisher's tests.Using stepwise logistic regression to construct an ISSNHL prognosis model.Subsequently,the ISSNHL prognostic model nomogram was constructed using R software.The effectiveness of using the area under the curve to evaluate the column plot model in predicting the prognosis of ISSNHL.Evaluate the clinical applicability of the column chart model using cal⁃ibration curve analysis and decision curve analysis.Results The ISSNHL prognostic model nomogram constructed in this study includes five variables based on age,time of onset,vertigo,NLR,MHR,and CAR.This nomogram showed good predictive value in both the training set(AUC:0.945,sensitivity:90.2%,specificity:87.0%)and the internal validation set(AUC:0.927,sensitivity:91.7%,specificity:90.0%).In addition,both the decision curve and cali⁃bration curve demonstrate the clinical effectiveness of this predictive model.Conclusion The column chart constructed in this study can effectively predict the prognosis of ISSNHL patients and promote clinical decision-making.

关 键 词：特发性突发性感音神经性耳聋 预后 列线图 

分 类 号：R764.431[医药卫生—耳鼻咽喉科]