构建高甘油三酯血症性急性胰腺炎患者短期复发再入院预警模型并验证  

Establishment and validation of a risk early warning model for recurrent readmission in patients with hypertriglyceridemic acute pancreatitis in the short term

作　　者：谢芬 余娇[1] 宋思蓓 黄琳[1] XIE Fen;YU Jiao;SONG Sibei;HUANG Lin(Department of Digestive,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China)

机构地区：[1]南昌大学第二附属医院消化科,江西南昌330006

出　　处：《中国现代医生》2025年第3期27-31,共5页China Modern Doctor

摘　　要：目的分析高甘油三酯血症性急性胰腺炎(hypertriglyceridemic acute pancreatitis,HTG-AP)患者短期内复发再入院的相关因素,构建风险预警模型并验证。方法选取2023年1月至11月收治的176例HTG-AP患者作为研究对象,根据短期内是否复发再入院分为复发再入院组(n=53)和非复发再入院组(n=123),使用单因素和多因素Logistic回归构建风险预测模型。选取2023年12月至2024年4月收治的53例HTG-AP患者进行模型的外部验证。结果176例HTG-AP患者短期内出现复发再入院的概率为30.11%。根据单因素和Logistic多因素分析,结果显示急性生理与慢性健康评分系统Ⅱ评分≥8分、Ranson评分≥3分、中性粒细胞与淋巴细胞比值、血清淀粉酶、乳酸脱氢酶为HTG-AP患者短期内出现复发再入院的独立危险因素,Ca^(2+)为其保护因素(P<0.05)。176例HTG-AP患者根据H-L拟合优度检验结果显示,χ^(2)=5.212,P=0.735;曲线下面积(area under the curve,AUC)为0.877(P<0.001,95%CI:0.824~0.931),敏感度为86.80%,特异性为73.20%,最大约登指数为0.600;53例HTG-AP患者根据H-L拟合优度检验结果显示,χ^(2)=3.391,P=0.907;AUC为0.881(P<0.001,95%CI:0.791~0.971),敏感度为78.10%,特异性为81.00%,最大约登指数为0.591。研究结果证明该模型预测HTG-AP患者短期内复发的拟合优度良好,具有较好的预测效能。结论HTG-AP患者短期内复发再入院受多重因素综合影响,构建的风险预测模型具有良好的一致性与区分度。Objective To analyze the related factors of recurrent readmission in patients with hypertriglyceridemic acute pancreatitis(HTG-AP)in the short term,and to construct and verify the risk early warning model.Methods A total of 176 patients with HTG-AP admitted from January to November 2023 were selected as the research objects.According to whether they were readmitted and recurred in the short term,they were divided into recurrent readmission group(n=53)and non-recurrent readmission group(n=123).Univariate and multivariate Logistic regression were used to construct the risk prediction model.A total of 53 HTG-AP patients admitted from December 2023 to April 2024 were selected for external validation of the model.Results The probability of recurrence and readmission in 176 patients with HTG-AP in the short term was 30.11%.According to univariate and Logistic multivariate analysis,the results showed acute physiology and chronic health evaluation Ⅱ score≥8 points,Ranson score≥3 points,neutrophil to lymphocyte ratio,serum amylase and lactic dehydrogenase were independent risk factors for recurrence and readmission in HTG-AP patients in the short term,while Ca^(2+) was the protective factor(P<0.05).According to the H-L goodness of fit test results of 176 patients with HTG-AP,χ^(2)=5.212,P=0.735;Area under the curve(AUC)was 0.877(P<0.001,95%CI:0.824-0.931),the sensitivity was 86.80%,the specificity was 73.20%,and the maximum Youden index was 0.600.According to the H-L goodness of fit test results of 53 patients with HTG-AP,χ^(2)=3.391,P=0.907;AUC was 0.881(P<0.001,95%CI:0.791-0.971),the sensitivity was 78.10%,the specificity was 81.00%,and the maximum Youden index was 0.591.The results showed that the model had good goodness of fit and good predictive efficacy in predicting the short-term recurrence of HTG-AP patients.Conclusion The short-term recurrence and readmission of HTG-AP patients are affected by multiple factors,and the risk prediction model has good consistency and discrimination.

关 键 词：高甘油三酯血症性急性胰腺炎 复发再入院 急性生理与慢性健康评分系统Ⅱ 中性粒细胞与淋巴细胞比值 风险预警模型 

分 类 号：R576[医药卫生—消化系统]