艾滋病合并结核病危险因素及预测模型构建  

Risk factors for tuberculosis in AIDS patients and establisninent of prediction model

作　　者：沈晓萍 张维东 汤佳媚 姚冠羽 董其峰 SHEN Xiao-ping;ZHANG Wei-dong;TANG Jia-mei;YAO Guan-yu;DONG Qi-feng(Hangzhou Xiri Hospital,Hangzhou,Zhejiang 310000,China)

机构地区：[1]杭州市西溪医院外科,浙江杭州310000

出　　处：《中华医院感染学杂志》2024年第11期1606-1610,共5页Chinese Journal of Nosocomiology

基　　金：浙江省科研基金资助项目(2021HG010051)。

摘　　要：目的调查艾滋病合并结核病患者流行病学并构建预测模型.方法将2019年1月-2021年12月杭州市西溪医院收治的2736例艾滋病患者纳入研究,其中72例艾滋病合并结核病患者纳入艾滋病合并结核病组,2664例艾滋病患者纳入单纯艾滋病组,回顾性收集患者临床资料;分析艾滋病合并结核病现况,艾滋病合并结核病诊断治疗信息,通过Logistic回归分析法分析艾滋病合并结核病的危险因素;构建列线图预测模型,采用受试者工作特征(ROC)曲线分析其对艾滋病合并结核病的预测价值.结果2019-2021年新确诊艾滋病合并结核病发生率为2.63%,各年艾滋病合并结核病发病率差异无统计学意义;2019、2020、2021年艾滋病合并结核病患者感染部位、结核病史、出现症状至就诊时间、抗结核治疗比较差异无统计学意义;Logistic回归分析结果显示,艾滋病感染途径静脉吸毒、文化程度、CD4+细胞数、体质量指数(BMI)是艾滋病合并结核病的危险因素(P<0.05);构建艾滋病合并结核病风险因素的列线图预测模型,经Hosmer-Lemeshow拟合度检验结果显示,模型拟合的准确度较好;采用Logistic回归模型统计分析数据,得到艾滋病合并结核病风险模型的诊断概率logit(P)=-0.920+艾滋病感染途径×0.977+文化程度×0.554+CD4+细胞数×1.017-BMI×0.209;按照诊断概率logit(P)绘制艾滋病合并结核病的ROC曲线,当logit(P)>0.026时,曲线下面积(AUC)值为0.753,提示模型区分度较好.结论艾滋病合并结核病与多种因素密切相关,构建模型可早期筛查高危患者,并进行预防性干预.OBJECTIVE To investigate the epidemiology of AIDS patients with tuberculosis and construct a prediction model.METHODS Totally 2736 patients with acquired immune deficiency syndrome admitted to Hangzhou Xixi Hospital from Jan.2019 to Dec.2021 were included in the study,of which 72 patients with acquired immune deficiency syndrome combined with tuberculosis were included in the acquired immune deficiency syndrome combined with tuberculosis group and 2664 patients with acquired immune deficiency syndrome were included in the acquired immune deficiency syndrome simple group,and the clinical data of patients were retrospectively collected.The status of acquired immune deficiency syndrome and tuberculosis,information on diagnosis and treatment of acquired immune deficiency syndrome and tuberculosis were analyzed,and the risk factors of AIDS and tuberculosis were analyzed by Logistic regression analysis.A nomogram prediction model was constructed,and its predictive value for AIDS with tuberculosis was analyzed by receiver operating characteristic(ROC)curve.RESULTS From 2019 to 2021,the incidence of newly diagnosed AIDS with tuberculosis was 2.63%,and there was no statistical difference in the incidence rate of AIDS with tuberculosis in each year.In 2019,2020 and 2021,there was n0 statistically significant difference in the infection site,history of tuberculosis,time from symptoms to treatment,and anti tuberculosis treatment of AIDS patients with tuberculosis.Logistic regression analysis showed that intravenous drug use,education level,CD,+cell count,body mass index(BMI)were the risk factors of AIDS with tuberculosis(P<0.05).The nomogram prediction model of risk factors of AIDS combined with tuberculosis was constructed.The results of Hosmer Lemeshow fit test showed that the accuracy of model fitting was good.Logistic regression model was used to statistically analyze the data,and the diagnostic probability of the risk model of AIDS combined with tuberculosis was logit(P)=-0.920+AIDS infection route X 0.977+education lev

关 键 词：艾滋病 结核病 现况 危险因素 预测模型 

分 类 号：R512.91[医药卫生—内科学]