维持性血液透析患者自觉口干症状风险评估模型的构建与预测  

Construction and prediction of risk assessment model for symptoms of conscious xerostomin in maintenance hemodialysis patients

作　　者：李文晶 靳芳 韩素梅 张淑华 沈益琴 苏芹芹 LI Wenjing;JIN Fang;HAN Sumei;ZHANG Shuhua;SHEN Yiqin;SU Qinqin(Chinese People's Liberation Army Joint Logistics Support Force No.960 Hospital,Jinan 250000,China;Jinan Sangzidian Country Hospital,Jinan 250000,China;Hangzhou Xixi Hospital,Hangzhou 310000,China;Dongying Honggang Hospital,Dongying 257000,China)

机构地区：[1]中国人民解放军联勤保障部队第九六〇医院(山东省济南市,250000) [2]济南市桑梓店镇卫生院(山东省济南市,250000) [3]杭州市西溪医院(浙江省杭州市,310000) [4]东营市鸿港医院(山东省东营市,257000)

出　　处：《护理实践与研究》2024年第9期1266-1273,共8页Nursing Practice and Research

基　　金：杭州市卫生健康委科研项目(编号:2021WJCY371)。

摘　　要：目的探讨维持性血液透析患者自觉口干症状的影响因素,构建个体化风险评估列线图模型,并评价该模型的预测效果。方法选取医院2020年1月—2022年12月210例维持性血液透析患者为研究对象,采用自制一般资料调查问卷、简明口干评分量表(Simplified Xerostomia Inventory,SXI)、医院焦虑抑郁量表(The Hospital Anxiety and Depression Scale,HADS)完成现状调查,并根据SXI得分情况分为口干症组(>5分,n=96)和无口干症组(≤5分,n=114),再通过多因素Logistic回归分析维持性血液透析患者自觉口干症状的影响因素,并基于多因素Logistic回归分析结果构建个体化的风险评估列线图模型,最后采用Hosmer-Lemeshow检验、受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under curve,AUC)检验模型预测效果。结果本研究210例患者中有96例患者发生自觉口干症状,发生率为45.71%。多因素Logistic回归分析结果显示,糖尿病史、残余肾功能、透析前收缩压、透析间期超滤量、焦虑抑郁均为维持性血液透析患者自觉口干症状的独立影响因素(P<0.05);建立的个体化风险评估列线图模型的Hosmer-Lemeshow卡方检验显示,χ^(2)=8.830,P=0.357,模型的AUC为0.897,95%CI为0.840~0.953,对应灵敏度、特异度分别为0.823、0.850,模型预测准确率为85.71%。结论维持性血液透析患者自觉口干症状发生率较高且与糖尿病史、残余肾功能、透析前收缩压、透析间期超滤量、焦虑抑郁因素密切相关,本研究以此为依据建立的个体化风险评估列线图模型具有良好的预测效能,能为临床预测患者自觉口干症状提供一定的前瞻性依据。Objective To explore the influencing factors of conscious xerostomin symptoms in maintenance hemodialysis patients,to construct a personalized risk assessment line diagram model,and evaluate the predictive effect of the model.Methods 210 cases of maintenance hemodialysis patients from January 2020 to December 2022 were selected as the study subjects.The status survey was completed by using the self-made general information questionnaire,the Simplified Xerostomia Inventory(SXI),and the Hospital Anxiety and Depression Scale(HADS).According to the SXI score,they were divided into the xerostomia group(>5 points,n=96)and the non-xerostomia group(≤5 points,n=114).The influencing factors of conscious xerostomia symptoms of maintenance hemodialysis patients were analyzed by multivariate Logistic regression.A personalized risk assessment column chart model was constructed based on the results of multivariate Logistic regression analysis.Finally,the Hosmer-Lemeshow test and the area under the receiver characteristic(ROC)curve(AUC)were used to test the prediction effect of the model.Results 96 among the 210 patients showed the symptoms of conscious xerostomin,with an incidence of 45.71%.The results of multivariate Logistic regression analysis showed that diabetes history,residual renal function,pre-dialysis systolic blood pressure,dialysis interval ultrafiltration volume,and anxiety and depression were all independent influencing factors of conscious xerostomin symptoms in maintenance hemodialysis patients(P<0.05).The Hosmer-Lemeshow chi-square test of the established personalized risk assessment line diagram model showed thatχ^(2)=8.830,P=0.357,the AUC of the model was 0.897,the 95%CI was 0.840~0.953,the corresponding sensitivity and specificity were 0.823 and 0.850,respectively,and the prediction accuracy of the model was 85.71%.Conclusion Maintenance hemodialysis patients had a high incidence of conscious xerostomin symptoms and were closely related to diabetes history,residual renal function,pre-dialysis systo

关 键 词：维持性血液透析 自觉口干症 影响因素 个体化风险评估 列线图模型 预测效果 

分 类 号：R473.5[医药卫生—护理学]