老年特应性皮炎发病的居家习惯及外界环境危险因素分析及预测模型建立  

Analysis of risk factors and construction of a prediction model for atopic dermatitis in the elderly

作　　者：邱娇娇 陈伟 刘爱美 杨瑶 QIU Jiaojiao;CHEN Wei;LIU Aimei;YANG Yao(Department of Dermatology,the Second Afiliated Hospital of Chengdu Medical College,China National Nuclear Corporation 416 Hospital,Chengdu 610083,China)

机构地区：[1]成都医学院第二附属医院/核工业四一六医院,成都610066

出　　处：《实用皮肤病学杂志》2024年第6期332-336,共5页Journal of Practical Dermatology

基　　金：四川省医学会青年创新课题(Q20006)。

摘　　要：目的探索诱导老年特应性皮炎(AD)发病的居家习惯及外界环境危险因素,并以此建立预测模型,提高对老年AD发病诱因的认知,为老年AD的诊断提供参考依据。方法回顾性分析2016年1月至2024年1月成都医学院附属第二医院/核工业四一六医院皮肤科门诊及住院收治的疑似老年AD患者共计407例,并在初次就诊时填写居家习惯及外界环境问卷调查表。结果共筛选出321例患者,根据是否确诊AD分为AD组(n=224)和非AD组(n=97)。采用单因素分析筛选导致老年AD发病的相关因素,并对其进行多因素Logistic回归分析,筛选出老年AD发病的独立危险因素。采用R软件建立列线图预测模型,并采用受试者工作特征(ROC)曲线、校准曲线、Hosmer-Lemeshow拟合优度检验对预测模型区分度和校准度进行评价。单因素分析结果显示,在是否至少1~2周会更换床单和被套、洗澡频率、PM 2.5、温度和湿度5个方面,AD组与非AD组差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示,2周内不更换床单被套、高PM 2.5、低湿度、低温是老年AD发病的独立危险因素(P<0.05)。预测模型的ROC曲线及校准曲线显示曲线下面积(AUC)/一致性指数(C-index)为0.8576(95%CI 0.812~0.9032),区分度良好。校准曲线显示预测几率与实际几率的平均绝对误差为0.021,Hosmer-Lemeshow检验P值为0.4474(>0.05),一致性好。结论2周内不更换床单被套、高PM 2.5、低湿度、低温是老年AD发病的独立危险因素,基于此建立的列线图预测模型具有良好区分度和一致性,具有良好的预测能力。Objective To explore the risk factors related to atopic dermatitis(AD)in the elderly,establishing a prediction model to enhance understanding of the etiology,and provide a reference for the diagnosis of AD in the elderly.Methods A retrospective analysis was performed on 407 elderly patients possiblly diagnosed with AD,who were treated at department of dermatology,the second affifiliated hospital of chengdu medical college from January 2016 to January 2024.Detailed information regarding patients'home habits and external environment was collected via a questionnaire during their initial visit.Results A total of 321 patients were enrolled in this study,and were divided into AD group(224)and non-AD group(97)according to confirmed diagnosis.Univariate analysis was used to identify factors associated with AD in the elderly,followed by multivariate Logistic regression analysis to determine independent risk factors.The nomogram prediction model was established using R software,and the model's discriminatory ability and calibration were assessed using the receiver operating characteristic(ROC)curve,calibration curve,and Hosmer-Lemeshow goodness of ft test.Results The univariate analysis revealed that five factorsfrequency of changing bed linens and pillowcases within 2 weeks,bathing frequency,PM 2.5 levels,temperature,and humidity-demonstrated statistically significant differences between the AD and non-AD groups(P<0.05).Multivariate logistic regression analysis revealed that failing to change bed linens and pillowcases within a two-week period,elevated PM 2.5 levels,low humidity,and low temperature were independent risk factors for AD in the elderly(P<0.05).The ROC curve and the calibration curve of the prediction model showed an AUC/C-index of 0.8576(95%CI:0.812-0.9032),with good discriminatory ability.The calibration curve showed the mean absolute error of 0.021 between the predicted and actual probability.The Hosmer-Lemeshow test yielded a P-value of 0.4474(>0.05),indicating good consistency.Conclusion Failing to chan

关 键 词：皮炎 特应性 老年人 居家习惯 外界环境 危险因素 预测模型 

分 类 号：R758.23[医药卫生—皮肤病学与性病学]