乌鲁木齐市子痫前期发病的高危因素分析及Nomogram预测模型的构建与验证  

Analysis of high-risk factors of preeclampsia in Urumqi and construction and verification of Nomogram prediction model

作　　者：程备 段茉莉 丁桂凤 CHENG Bei;DUAN Mo-li;DING Gui-feng(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang Uygur Autonomous Region 830000,China;不详)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830000 [2]乌鲁木齐市妇幼保健院,新疆乌鲁木齐830000

出　　处：《现代预防医学》2024年第11期1938-1943,共6页Modern Preventive Medicine

基　　金：新疆维吾尔自治区自然科学基金项目(2022D01A29)。

摘　　要：目的探索乌鲁木齐市子痫前期发病的高危因素,建立风险预测模型并验证。方法通过乌鲁木齐市妇幼保健院临床科研一体化平台回顾性收集2021年2月—2023年2月产检孕妇6138例,收集孕妇的一般资料、孕产史、妊娠期合并症,按7:3随机划分建模组4308例与验证组1830例。Logistic回归模型分析方法构建Nomogram预测模型,并采用受试者工作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)评估列线图预测模型的区分度、校准度和临床实用性。结果高龄(OR=1.887,95%CI:1.535~2.319)、超重(OR=3.221,95%CI:2.699~3.844)、家族史(OR=1.575,95%CI:1.254~1.979)、高血压病史(OR=17.552,95%CI:7.021~43.882)、妊娠期高血压(OR=1.827,95%CI:1.388~2.405)、子痫前期病史(OR=6.216,95%CI:3.578~10.770)、首次怀孕(OR=2.384,95%CI:1.777~3.200)均为乌鲁木齐市子痫前期发病的独立危险因素。ROC曲线检验结果表明,建模组和验证组曲线下面积及95%CI分别为0.762(0.742~0.782)、0.765(0.734~0.796)。校准曲线和DCA曲线显示列线图具有良好的精准性和临床实用性。结论本研究建立的列线图预测模型具有良好的预测能力,为临床医护人员筛选高危患者提供重要的参考,应尽早采取干预措施预防其进一步进展,改善母婴结局。Objective To investigate the high-risk factors for preeclampsia in Urumqi,establish a risk prediction model,and validate its effectiveness.Methods A total of 6138 pregnant women undergoing antenatal examination from February 2021 to February 2023 were collected through the integrated platform of clinical research in Urumqi Maternal and Child Health Hospital.General data,pregnancy history,and pregnancy complications were recorded.The patients were randomly divided into a modeling group(n=4308)and a validation group(n=1830)in a 7:3 ratio.The logistic regression model analysis method was used to construct a Nomogram prediction model.The receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA)were employed to assess the discrimination,calibration,and clinical applicability of the prediction model.Results The advanced age(OR=1.887,95%CI:1.535-2.319),overweight(OR=3.221,95%CI:2.699-3.844),family history(OR=1.575,95%CI:1.254-1.979),hypertension history(OR=17.552,95%CI:7.021-43.882),hypertension complicating pregnancy(OR=1.827,95%CI:1.388-2.405),preeclampsia history(OR=6.216,95%CI:3.578-10.770),and primiparity(OR=2.384,95%CI:1.777-3.200)were identified as independent risk factors of preeclampsia in Urumqi.The results of ROC curve test showed that the area under the curve and 95%CI of the model group were 0.762(0.742-0.782),and for the validation group were 0.765(0.734-0.796).The calibration curve and DCA curve demonstrated that the Nomogram had good accuracy and clinical applicability.Conclusion The established nomogram prediction model exhibited good predictive ability and provides an important reference for clinical practitioners to identify high-risk patients.Early intervention measures should be implemented to prevent further progression and improve maternal and infant outcomes.

关 键 词：子痫前期 高危因素 风险预测模型 校准曲线 

分 类 号：R714.25[医药卫生—妇产科学]