老年高血压患者合并脑卒中的影响因素分析及列线图模型构建  

Analysis of influencing factors and construction of nomogram model in elderly patients with hypertension complicated with stroke

作　　者：王瑞 曾泓辑 王雯娟 刘雅慧 卫姝帆 田庆丰[1] WANG Rui;ZENG Hong-ji;WANG Wen-juan;LIU Ya-hui;WEI Shu-fan;TIAN Qing-feng(Department of Social Medicine and Health Management,School of Public Health,Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学公共卫生学院社会医学与卫生事业管理教研室,河南郑州450000

出　　处：《现代预防医学》2024年第14期2620-2627,共8页Modern Preventive Medicine

基　　金：国家重点研发计划资助项目(2020YFC2006100)。

摘　　要：目的基于社区健康调查识别老年高血压患者患脑卒中的影响因素,并根据影响因素建立列线图预测模型。方法于2022年采用多阶段抽样的方法抽取河南省郑州市居住半年以上的居民进行社区健康调查,使用单因素和多因素分析筛选老年高血压患者合并脑卒中的影响因素并构建列线图预测模型,ROC曲线、校准曲线、DCA决策曲线用于验证列线图模型的准确性和稳定性。结果本次研究共纳入15995例老年高血压患者,将总体以7:3随机分为训练集与验证集。模型构建:训练集二元logistics分析结果显示,年龄、性别、腰围、血压控制是否达标、是否超重或肥胖、是否运动、是否吸烟、是否饮酒、是否饮食均衡、是否患有血脂异常、是否有心脏病史是患脑卒中的独立影响因素。根据多因素分析结果构建列线图模型。模型验证:训练集和验证集ROC曲线下面积分别为0.748\0.779、校准曲线拟合良好,表明该模型具有良好的预测价值。结论本研究建立了一个老年高血压患者合并脑卒中的列线图预测模型,其中包括人口学特征、健康状况和生活方式,该模型具有较好的准确性和稳定性,有助于筛查高危个体,提供临床决策和预防建议。Objective To identify the influencing factors of stroke in elderly patients with hypertension based on community health survey,and establish a nomogram prediction model according to the influencing factors.Methods In 2022,the multi-stage sampling method was used to select the residents of Zhengzhou City,Henan province who lived for more than half a year for community health survey,and univariate and multivariate analysis was used to screen the influential factors of elderly hypertension patients complicated with stroke,and a nomogram prediction model was constructed.ROC curve,calibration curve and DCA decision curve are used to verify the accuracy and stability of the nomogram model.Results A total of 15995 elderly patients with hypertension were included in this study.The original data set was randomly divided into a training set and a validation set at 7:3.Model construction:The results of binary logistics analysis of the training set showed that age,gender,waist circumference,blood pressure control,overweight or obesity,exercise,smoking,drinking,balanced diet,dyslipidemia and heart disease were independent influencing factors for stroke.A nomogram model was constructed according to the results of multi-factor analysis.Model validation:the area under the ROC curve of the training set and the verification set is 0.748\\0.779 respectively,and the calibration curve is well fitted,indicating that the model has good predictive value.Conclusion In this study,we established a nomogram prediction model for elderly hypertensive patients with stroke,including demographic characteristics,health status and lifestyle.The model is accurate and stable,which can help to screen high-risk individuals,provide clinical decision-making and prevention recommendations.

关 键 词：老年人 高血压 脑卒中 影响因素 列线图 

分 类 号：R544.1[医药卫生—心血管疾病]