2型糖尿病膀胱过度活动症的危险因素分析及列线图预测模型构建的研究  

Analysis of risk factors for diabetic overactive bladder and construction of a prediction model based on nomogram

作　　者：李丹[1] 胡思颖 徐玉节 陈明卫[1] LI Dan;HU Siying;XU Yujie(Department of Endocrinology,The First Afiliated Hospital of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学第一附属医院内分泌科,合肥230000 [2]皖南医学院第一附属医院全科医学科 [3]皖南医学院第一附属医院泌尿外科

出　　处：《中国糖尿病杂志》2024年第11期801-806,共6页Chinese Journal of Diabetes

基　　金：2022年度芜湖市科技项目(2022jc62);皖南医学院2022年度校重点项目科研基金(WK2022ZF07)。

摘　　要：目的 建立T2DM膀胱过度活动症(OAB)的风险预测模型,验证模型的诊断效能及临床价值。方法 回顾性分析2020年1月至2023年10月于皖南医学院第一附属医院接受尿动力学检查的298例T2DM患者临床资料。根据尿动力学结果分为单纯T2DM组(n=218)和合并OAB组(OAB,n=80)。采用Logistic回归分析T2DM患者OAB的影响因素,根据危险因素建立列线图预测模型。采用受试者工作特征(ROC)曲线、校准图和决策曲线(DCA)评估该模型的诊断效能。结果Logistic回归分析显示,年龄、DM病程、BMI、Hb A1c、DPN、OAB症状评分(OABSS)是T2DM患者OAB的影响因素。基于上述影响因素构建的列线图模型预测效能良好,ROC曲线下面积为0.937,校准图显示预测T2DM发生OAB概率与实际尿动力检出率基本平行。DCA曲线分析显示,该模型有较高的临床应用价值。结论 年龄、DM病程、OABSS、BMI、Hb A1c、DPN构建的列线图模型,对T2DM患者OAB预测效能较好,具有一定的临床应用价值。Objective To establish a risk prediction model for type 2 diabetes mellitus(T2DM) related overactive bladder(OAB),and to verify the diagnostic efficacy and clinical application value of the model. Methods The clinical data of 298 patients with diabetes who underwent urodynamic examination in The First Affiliated Hospital of Wannan Medical College from January 2020 to October 2023 were analyzed retrospectively. According to the results of urodynamics,all the patients were divided into T2DM group(T2DM,n=218) and OAB group(OAB,n=80). The risk factors of OAB were analyzed by logistic regression,and the prediction model was established according to the risk factors. Receiver operating characteristic(ROC) curve,calibration diagram and decision curve analysis(DCA) were used to analyze and evaluate the diagnostic efficiency of the model. Results Logistic regression analysis results showed that age,DM duration,BMI,Hb A1c,DPN and OAB score(OABSS),were independent predictors for OAB.The nomogram model built based on the above risk factors had good predictive ability,and its area under ROC curve was 0. 937. The correction curve showed that the predicted probability of OAB in patients with type 2 diabetes mellitus was basically parallel to the actual probability of urodynamic detection. The results of DCA show that the model has high clinical value. Conclusions The nomogram model built by age,DM duration,OABSS,BMI,Hb A1c,DPN has high predictive efficacy for OAB in patients with T2DM.

关 键 词：糖尿病膀胱功能障碍 膀胱过度活动症 列线图 临床预测模型 

分 类 号：R694[医药卫生—泌尿科学] R587.2[医药卫生—外科学]