基于全身免疫炎症指数的预测帕金森病患者伴发抑郁的列线图模型构建  

Construction of a Nomogram Model for Predicting the Risk of Depression in Patients with Parkinson's Disease Based on Systemic Immune-Inflammation Index

作　　者：郝思佳 翟志远 桑雪莲 陈成 卢军 王国庆 曹向阳[3] 郑金龙 Hao Sijia;Zhai Zhiyuan;Sang Xuelian;Chen Cheng;Lu Jun;Wang Guoqing;Cao Xiangyang;Zheng Jinlong(Affiliated Huai'an Clinical College of Xuzhou Medical University,Huai'an 223001,China;Department of Neurology,Fudan University Affiliated Pudong Medical Center,Shang'hai 200120,China;Department of Neurology,Huai'an Second People's Hospital,Huai'an 223001,China)

机构地区：[1]徐州医科大学附属淮安临床学院,淮安223001 [2]复旦大学附属浦东医院神经内科,上海200120 [3]淮安市第二人民医院神经内科,淮安223001

出　　处：《成都医学院学报》2024年第2期288-293,共6页Journal of Chengdu Medical College

基　　金：江苏省卫生健康委员会科研课题(No:H2018060);淮安市卫生健康委员会科研项目(No:HAWJ202011)。

摘　　要：目的 探讨全身免疫炎症指数(SII)与帕金森病(PD)患者发生抑郁的关系及其预测价值。方法 选取2017年1月至2022年12月徐州医科大学附属淮安临床学院收治的PD患者146例为PD组,同期于该院体检的健康者160例为对照组。根据汉密尔顿抑郁量表24项(HAMD-24)评分将PD组患者分为PD不伴抑郁组(n=77)、PD轻度抑郁组(n=51)、PD中重度抑郁组(n=18)。收集各组一般资料及实验室资料,采用多因素Logistic回归分析筛选PD患者发生抑郁的影响因素,并据此构建列线图预测模型。结果 PD组淋巴细胞计数和血小板计数均低于对照组,SII高于对照组(P<0.05)。PD不伴抑郁组、PD轻度抑郁组、PD中重度抑郁组3组间的左旋多巴等效剂量(LED)、病程、SII、H-Y分期、统一帕金森病评定量表第三部分(UPDRSⅢ)评分比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,较高的SII和UPDRSⅢ评分是PD患者发生抑郁的独立危险因素。基于SII及UPDRSⅢ评分构建的列线图模型的ROC曲线显示,SII诊断PD患者发生抑郁的AUC为0.894(95%CI:0.845~0.943,P<0.05),提示该模型具有良好的区分度;决策曲线和校准曲线提示该模型具有较好的临床一致性和适用性。结论 基于SII及UPDRSⅢ评分构建的列线图模型对PD患者伴发抑郁具有良好的预测价值。Objective To explore the relationship between systemic immune-inflammation index(SII)and the occurrence of depression in patients with Parkinson's disease(PD)and its predictive value.Methods A total of 146 PD patients admitted to Huai'an First People's Hospital from January 2017 to December 2022 were selected as the PD group,and 160 healthy individuals undergoing physical examination during the same period in the same hospital were selected as the control group.And the PD patients were divided into PD without depression group(n=77),mild depression group(n=51),and moderate to severe depression group(n=18)based on their Hamilton Depression Rating Scale-24(HAMD-24)score.Multivariate Logistic regression analysis was conducted on the general data and laboratory data collected to screen the influencing factors of depression in PD patients,and a nomogram prediction model was constructed accordingly.Results The lymphocyte count and platelet count in the PD group were significantly lower than those in the control group,while the SII was significantly higher than that in the control group(P<0.05).There were statistically significant differences in levodopa equivalent dose(LED),disease duration,SII,Hoehn-Yahr(H-Y)staging,and Unified Parkinson's Disease Rating ScaleⅢ(UPDRSⅢ)scores among the PD without depression group,mild depression group,and moderate to severe depression group(P<0.05).The results of the multivariate Logistic regression analysis showed that higher SII and UPDRS III scores were independent risk factors for depression in PD patients.The ROC curve of the nomogram model constructed based on SII and UPDRS III scores showed that the AUC of depression in PD patients diagnosed by SII was 0.894(95%CI 0.845-0.943,P<0.05),indicating good discriminative ability of the model.Additionally,the decision curve and calibration curve analysis suggested good clinical consistency and applicability of the model.Conclusion The nomogram model constructed based on SII and UPDRS III scores has good predictive value for depressio

关 键 词：帕金森病 抑郁 全身免疫炎症指数 列线图 炎症 

分 类 号：R742.5[医药卫生—神经病学与精神病学]