中青年女性压力性尿失禁的列线图模型构建  

Construction a nomogram model for predicting stress urinary incontinence in young and middle-aged women

作　　者：周萍[1] 木卡带司·阿不都外力 梁泽兰[1] 刘忆冰 侯铭[1] Zhou Ping;Mukadaisi·Abuduwaili;Liang Zelan;Liu Yibing;Hou Ming(Urinary Center,Xinjiang Uygur Autonomous Region People′s Hospital,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院泌尿中心,乌鲁木齐830000

出　　处：《中国医师进修杂志》2024年第9期803-807,共5页Chinese Journal of Postgraduates of Medicine

基　　金：新疆维吾尔自治区自然科学基金(2023D01C82)。

摘　　要：目的构建预测中青年女性压力性尿失禁(SUI)的列线图模型。方法采用抽样调查的方法,2021年5月至2023年10月对乌鲁木齐地区社区2个街道中青年女性发放问卷1000份,调查基本情况、生活习惯和妇科相关情况;采用国际尿失禁咨询委员会尿失禁问卷简表诊断SUI,根据结果分为SUI组和对照组。收回786份。分析两组调查结果,构建预测中青年女性发生SUI的列线图模型并验证。结果入选的786例青年女性中,SUI组147例,对照组639例。SUI组年龄、体质量指数(BMI)及糖尿病、慢性便秘、分娩史、巨大儿分娩史、盆底功能障碍发生率明显高于对照组[(44.51±8.20)岁比(38.60±12.35)岁、(27.31±4.53)kg/m^(2)比(24.28±4.38)kg/m^(2)、13.61%(20/147)比3.44%(22/639)、19.05%(28/147)比5.01%(32/639)、90.48%(133/147)比75.90%(485/639)、17.01%(25/147)比3.44%(22/639)和11.56%(17/147)比3.29%(21/639)],差异有统计学意义(P<0.01)。多因素Logistic回归分析结果显示,年龄>44岁、BMI≥30 kg/m^(2)、糖尿病、慢性便秘、分娩史、巨大儿分娩史和盆底功能障碍是中青年女性发生SUI的独立危险因素(RR=1.511、2.543、4.636、4.293、2.526、6.220和5.834,95%CI 1.007~2.268、1.661~3.894、2.281~9.422、2.339~7.881、1.374~4.643、3.205~12.071和2.641~12.888,P<0.05或<0.01)。基于年龄、BMI、糖尿病、慢性便秘、分娩史、巨大儿分娩史和盆底功能障碍构建预测中青年女性发生SUI的列线图模型。将数据集随机抽取550例作为训练集,剩余236例作为验证集,绘制受试者工作特征曲线,结果显示训练集曲线下面积为0.818(95%CI 0.773~0.862),验证集曲线下面积为0.826(95%CI 0.764~0.889);采用验证集对模型进行Hosmer-Lemeshow拟合优度检验,结果显示此列线图模型具有较高的可信度(χ^(2)=8.48,P>0.05)。结论中青年女性SUI的发生率较高,年龄>44岁、BMI≥30 kg/m^(2)、糖尿病、慢性便秘、分娩史、巨大儿分娩史和盆底功能障碍是中�Objective To construct a nomogram model for predicting stress urinary incontinence(SUI)in young and middle-aged women.Methods Using a sampling survey method,1000 questionnaires were distributed to young and middle-aged women in 2 streets of Urumqi community from May 2021 to October 2023 to investigate their basic situation,lifestyle habits and gynecological related information.The International Urinary Incontinence Advisory Committee urinary incontinence questionnaire was used to diagnose SUI,and the patients were divided into SUI group and control group based on the results.Seven hundred and eighty-six questionnaires were collected.The survey results of the two groups were analyzed,and a nomogram model for predicting the occurrence of SUI in young and middle-aged women was constructed and validated.Results Among the 786 young and middle-aged women,there were 147 cases in the SUI group and 639 cases in the control group.The age,body mass index(BMI),and the incidences of diabetes,chronic constipation,delivery history,macrosomia delivery history,pelvic floor dysfunction in SUI group were significantly higher than those in control group:(44.51±8.20)years vs.(38.60±12.35)years,(27.31±4.53)kg/m^(2) vs.(24.28±4.38)kg/m^(2),13.61%(20/147)vs.3.44%(22/639),19.05%(28/147)vs.5.01%(32/639),90.48%(133/147)vs.75.90%(485/639),17.01%(25/147)vs.3.44%(22/639)and 11.56%(17/147)vs.3.29%(21/639),and there were statistical differences(P<0.01).Multivariate Logistic regression analysis result showed that age>44 years,BMI≥30 kg/m^(2),diabetes,chronic constipation,delivery history,macrosomia delivery history and pelvic floor dysfunction were independent risk factors for SUI in young and middle-aged women(RR=1.511,2.543,4.636,4.293,2.526,6.220 and 5.834;95%CI 1.007 to 2.268,1.661 to 3.894,2.281 to 9.422,2.339 to 7.881,1.374 to 4.643,3.205 to 12.071 and 2.641 to 12.888;P<0.05 or<0.01).The age,BMI,diabetes,chronic constipation,delivery history,macrosomia delivery history and pelvic floor dysfunction were used as predictors to construct

关 键 词：尿失禁 压力性 女性 流行病学 列线图 

分 类 号：R711.59[医药卫生—妇产科学]