白内障超声乳化术后干眼的危险因素及列线图预测模型建立  

Risk factors of dry eye after phacoemulsification and establishment of nomogram prediction model

作　　者：黄芝影 张萍 徐蓓 HUANG Zhi-ying;ZHANG Ping;XU Bei(Operating Room,Jiangsu Provincial People's Hospital,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210000,Jiangsu,China)

机构地区：[1]江苏省人民医院·南京医科大学第一附属医院手术室,江苏南京210000

出　　处：《川北医学院学报》2024年第12期1724-1728,共5页Journal of North Sichuan Medical College

基　　金：江苏省科技项目(BK20231368)。

摘　　要：目的:探讨白内障超声乳化术后(Phaco+IOL)患者发生干眼的危险因素,并构建其列线图预测模型。方法:回顾性分析1034例施行Phaco+IOL治疗的白内障患者的临床资料。依据患者术后3个月是否出现干眼将患者分为干眼组(n=413)和非干眼组(n=621)。收集患者临床资料,通过多因素Logistic回归分析确立白内障Phaco+IOL术后患者干眼发生的独立危险因素,依据多因素分析结果构建白内障Phaco+IOL术后患者干眼发生的列线图预测模型,使用受试者工作特征(ROC)曲线验证该模型的预测效能。结果:1034例患者中,有413在发生干眼,发生率39.94%(413/1034)。两组年龄、角膜塑形镜佩戴史、合并糖尿病、合并类风湿关节炎、晶状体核硬度分级、手术时间、OSST、睑板腺分泌评分、睑脂粘度分级及结膜松弛分级比较,差异有统计学意义(P<0.05)。Logistic回归分析显示:有角膜塑形镜佩戴史、合并糖尿病、睑板腺分泌评分高(2~3级)、睑脂粘度分级高(3~5级)及结膜松弛分级高(3级)是白内障Phaco+IOL术后患者发生干眼的独立风险因素(P<0.05)。基于Logistic回归分析构建的列线图预测模型的(ROC)曲线显示,联合诊断曲线下面积为0.745(95%CI:0.718~0.772),敏感度和特异度分别为63.92%和73.75%。结论:有角膜塑形镜佩戴史、合并糖尿病、睑板腺分泌评分高(2~3级)、睑脂粘度分级高(3~5级)及结膜松弛分级高(3级)是白内障Phaco+IOL术后患者发生干眼的独立风险因素,基于以上风险因素构建的列线图预测模型具有较好的预测价值。Objective:To investigate the risk factors of dry eye in patients after phacoemulsification(Phaco+IOL),and to construct a nomogram prediction model.Methods:The clinical data of cataract patients treated with Phaco+IOL were retrospectively analyzed.A total of 1,034 patients were included.The patients were divided into dry eye group(n=413)and non-dry eye group(n=621)according to whether dry eye occurred 3 months after operation.The clinical data of patients were collected,and the independent risk factors of dry eye in patients after cataract Phaco+IOL surgery were established by multivariate Logistic regression analysis.Based on the results of multivariate analysis,a nomogram prediction model of dry eye in patients after cataract Phaco+IOL surgery was constructed.The receiver operating characteristic(ROC)curve was used to verify the predictive efficacy of the model.Results:Of the 1,034 patients,413 had dry eye,with an incidence of 39.94%(413/1,034).There were significant differences in age,wearing history of orthokeratology lens,diabetes mellitus,rheumatoid arthritis,lens nucleus hardness grading,operation time,OSST,meibomian gland secretion score,eyelid fat viscosity grading and conjunctival relaxation grading between the two groups(P<0.05).Logistic regression analysis showed that history of wearing orthokeratology lens,diabetes mellitus,high meibomian gland secretion score(grade 2~3),high blepharal fat viscosity grade(grade 3~5)and high conjunctival relaxation grade(grade 3)were independent risk factors for dry eye in patients after cataract Phaco+IOL(P<0.05).The ROC of the nomogram prediction model based on Logistic regression analysis showed that the AUC of the combined diagnosis was 0.745(95%CI:0.718~0.772),and the sensitivity and specificity were 63.92%and 73.75%,respectively.Conclusion:Orthokeratology lens wearing history,diabetes mellitus,high meibomian gland secretion score(grade 2~3),high meibomian fat viscosity grade(grade 3~5)and high conjunctival relaxation grade(grade 3)are independent risk factors for

关 键 词：白内障 超声乳化吸出 干眼 风险因素 列线图 

分 类 号：R776.1[医药卫生—眼科]