非哺乳期乳腺炎复发危险因素分析及预测模型的建立  

Analysis of risk factors for recurrence of non-puerperal mastitis and establishment of a prediction model

作　　者：郑洁莹 尚汇渊 仲文莉 陈颖[1,2] 乔佳君[2] 夏仲元 ZHENG Jie-ying;SHANG Hui-yuan;ZHONG Wen-li(Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]中日友好医院中医外科,北京100029 [3]北京朝阳中西医结合急诊抢救医院乳腺科,北京100020

出　　处：《中日友好医院学报》2024年第6期327-332,共6页Journal of China-Japan Friendship Hospital

基　　金：首都卫生发展科研专项(2022-2-4064);北京中医药大学研究生自主科研课题(ZJKT2023114)。

摘　　要：目的:探究非哺乳期乳腺炎(NPM)的复发危险因素,并基于相关危险因素构建列线图预测模型。方法:选取2021年9月—2023年3月中日友好医院中医外科临床治愈的NPM患者128例作为研究对象,根据患者是否复发分为复发组和未复发组。收集患者的临床资料并进行比较,应用单因素分析和多因素Logistics回归分析筛选NPM复发的独立危险因素,并以此构建列线图预测模型,进一步通过绘制预测模型的ROC曲线下面积(AUC)、校准曲线及决策分析曲线评估预测模型效能和临床实用性。结果:NPM患者分为复发组16例、未复发组112例。单因素及Logistic多因素回归分析结果发现超重/肥胖、原发性乳头凹陷、口服避孕药、手术治疗史为NPM复发的独立危险因素(P<0.05)。基于以上4个独立危险因素构建的列线图预测模型预测NPM复发风险。列线图ROC曲线分析结果显示,该模型的AUC为0.818(95%CI:0.710~0.926),CUT-OFF处对应的特异度为97.32%,灵敏度为25.00%。结论:超重/肥胖、原发性乳头凹陷、口服避孕药、手术治疗史是NPM复发的独立危险因素,早期识别复发危险因素有助于规避NPM复发风险。本研究构建的列线图预测模型对NPM复发有较好的准确性、校准度和临床实用性。Objective:To analyze the risk factors of non-puerperal mastitis(NPM)and build a nomogram prediction model.Methods:A total of 128 NPM patients from the Surgery Department of Traditional Chinese Medicine of China-Japan Friendship Hospital from September 2021 to March 2023 were retrospectively selected and divided into recurrence group and non-recurrence group.Clinical data of patients were collected and compared,univariate analysis and multivariate logistics regression analysis were applied to screen independent risk factors for NPM recurrence,and a nomogram prediction model was built based on the risk factors.Further,the prediction model was evaluated by drawing the area under ROC curve(AUC),calibration curve and decision analysis curve(DCA)of the predictive model.Results:Among 128 NPM patients,there were 16 cases in the recurrence group and 112 in the non-recurrence group.Univariate and Logistic regression analysis showed that obese/overweight,primary nipple depression,oral contraceptive and surgical history were independent risk factors for recurrence of NPM(P<0.05).The nomogram prediction model built based on the above four independent risk factors predicted the recurrence risk of NPM.ROC curve analysis results of the nomogram showed that the AUC of the model was 0.818(95%CI:0.710~0.926),and the corresponding specificity at CUT-OFF was 97.32%,sensitivity was 25.00%.Conclusion:Obese/overweight,primary nipple depression,oral contraceptive and surgical history are independent risk factors for NPM recurrence.Early identification of risk factors for recurrence is helpful to avoid the risk of NPM recurrence.The nomogram prediction model established in this study has good accuracy,calibration degree and clinical practicability for NPM recurrence.

关 键 词：非哺乳期乳腺炎 复发 危险因素 列线图 预测模型 

分 类 号：R655.8[医药卫生—外科学]