构建支气管动脉CT血管成像指导下介入治疗对咯血疗效的列线图模型并分析其预测效能  

Anomogram prediction model of the efficacy of bronchial artery CT angiography guided interventional therapy on hemoptysis and its efficacy analysis were constructed

作　　者：徐志涛 俞超 朱正欣 XU Zhitao;YU Chao;ZHU Zhengxin(Department of Interventional Diagnosis and Treatment,Shangrao People's Hospital,Shangrao,Jiangxi,334000,China;Department of Imaging,Shangrao People's Hospital,Shangrao,Jiangxi,334000,China)

机构地区：[1]上饶市人民医院介入诊疗科,江西上饶334000 [2]上饶市人民医院影像科,江西上饶334000

出　　处：《当代医学》2024年第21期135-138,共4页Contemporary Medicine

基　　金：上饶市科技计划项目(2022CZDX09)。

摘　　要：目的探讨构建支气管动脉CT血管成像(CT angiography,CTA)指导下介入治疗对咯血疗效的列线图模型并分析其预测效能。方法选取2020年3月至2022年8月上饶市人民医院收治的60例行支气管动脉CTA指导下介入治疗咯血患者作为研究对象,根据临床疗效分为疗效显著组(n=20)和疗效一般组(n=40)。所有患者均行支气管动脉CTA指导下介入治疗,采用单因素及多因素Logistic分析患者临床资料,运用R软件构建列线图模型,绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价模型的预测效能。结果两组年龄、病灶直径、病灶-胸膜距离分布及基础疾病史占比比较差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,年龄≥60岁、病灶直径≥20 mm、病灶-胸膜距离>1 cm是咯血患者行支气管动脉CTA指导下介入治疗疗效显著的独立影响因素(P<0.05)。Calibration验证、Bootstrap内部验证列线图模型显示,置信区间(confidence intrebal,CI)是0.839[95%CI(0.776,0.901)],校正曲线与理想曲线具有良好的贴合性。ROC曲线分析显示,列线图模型预测咯血患者行支气管动脉CTA指导下介入治疗疗效显著的曲线下面积为0.838[95%CI(0.783,0.898)],灵敏度为94.96%,特异度为90.14%。结论年龄≥60岁、病灶直径≥20 mm、病灶-胸膜距离>1 cm是咯血患者行支气管动脉CTA指导下介入治疗疗效显著的独立影响因素,且上述3个因素构建列线图模型具有较高的精准度及预测效能。Objective To explore the construction of a nomogram model for the efficacy of bronchial artery CT angiography(CTA)guided inter-ventional therapy on hemoptysis and its efficacy analysis.Methods 60 patients with hemoptysis who underwent bronchial artery CTA guided inter-ventional therapy in Shangrao People's Hospital from March 2020 to August 2022 were selected as the research subjects,and they were divided into the significant efficacy group(n=20)and the average efficacy group(n=40)according to clinical efficacy.All patients underwent bronchial artery CTA guided intervention therapy,patients'clinical data were analyzed by univariate and multivariate Logistic analysis,nomogram model was con-structed by R software,the receiver operating characteristic(ROC)curve was plotted to evaluate the predictive efficacy of the model.Results There were significant differences in age,lesion diameter,lesion-pleural distance distribution and proportion of underlying disease history between the two groups(P<0.05).Multivariate Logistic regression analysis showed that age≥60 years,lesion diameter≥20 mm and lesion-pleural distance>1 cm were independent influencing factors for the significant efficacy of bronchial artery CTA guided interventional therapy in patients with hemoptysis(P<0.05).The internal validation of the nomogram model by Calibration and Bootstrap showed that the confidence intrebal(CI)was 0.839[95%CI(0.776,0.901)],and the calibration curve had a good fit with the ideal curve.ROC curve analysis showed that the area under the curve of the nomo-gram model for predicting the significant efficacy of bronchial artery CTA guided interventional therapy in patients with hemoptysis was 0.838[95%CI(0.783,0.898)],sensitivity was 94.96%and specificity was 90.14%.Conclusion Age≥60 years,lesion diameter≥20 mm and lesion-pleural distance>1 cm were the independent influencing factors for the significant efficacy of bronchial artery CTA guided interventional therapy in pa-tients with hemoptysis,and the above three factors have hi

关 键 词：介入治疗 咯血 列线图模型 预测效能 支气管动脉CT血管成像 

分 类 号：R73[医药卫生—肿瘤]