糖尿病患者结肠镜检查低血糖发生风险预测模型的构建与评价  

Construction and evaluation of risk prediction model for hypoglycemia in patients with diabetes undergoing colonoscopy

作　　者：文红[1] 王莉慧[1] 黄心梅[1] 赖嘉微 殷青霞 刘赛君 江小密 WEN Hong;WANG Lihui;HUANG Xinmei;LAI Jiawei;YIN Qingxia;LIU Saijun;JIANG Xiaomi(Department of Gastroenterology,Southern Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院消化内科,510515

出　　处：《现代消化及介入诊疗》2024年第12期1405-1407,1413,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：国家自然科学基金资助项目(82200606)。

摘　　要：目的 针对糖尿病(diabetes mellitus,DM)患者结肠镜检查低血糖发生风险构建预测模型,评价其预测价值。方法 现选取于我院消化内科行结肠镜检查的DM患者500例开展研究,入院时间为2021年1月至2023年12月,对患者基线资料、检查数据等进行回顾分析,借助Logistic回归法对检查中导致低血糖发生的风险因素构建预测模型,评价模型的预测效能。结果 500例患者中,低血糖发生者共计72例,发生率14.40%;经Logistic回归分析显示,有饮酒史、禁食过久、肠道准备不达标以及复方聚乙二醇电解质散溶液(PEG-ELS)使用量>3 L是导致患者出现低血糖的高风险因素,P<0.05;构建模型患者的ROC曲线AUC为0.834,临界值最佳数值0.583,模型预测的灵敏度、特异度分别为93.48%、65.24%。结论 对于接受结肠镜检查的DM患者而言,饮酒、禁食过久、肠道准备不达标以及PEG-ELS用量过大均是导致低血糖的高风险因素,构建预测模型能够有效预测出以上风险,从而为患者的护理工作提供参考依据,减少低血糖的发生。Objective To establish a prediction model for the risk of hypoglycemia in patients with diabetes(DM) undergoing colonoscopy,and evaluate its predictive value.Methods A study was conducted on 500 DM patients who underwent colonoscopy in our hospital from January 2021 to December 2023.The baseline data and examination data of the patients were retrospectively analyzed,and a predictive model was constructed using logistic regression to identify the risk factors for hypoglycemia during the examination.The predictive performance of the model was evaluated.Results Among the 500 patients,there were a total of 72 cases of hypoglycemia,with an incidence rate of 14.40%;Logistic regression analysis showed that a history of alcohol consumption,prolonged fasting,inadequate bowel preparation,and the use of compound polyethylene glycol electrolyte powder solution(PEG-ELS) exceeding 3L were high-risk factors for hypoglycemia in patients,with P<0.05.The ROC curve AUC of the model patients was 0.834,and the optimal critical value was 0.583.The sensitivity and specificity of the model prediction were 93.48% and 65.24%,respectively.Conclusion For DM patients undergoing colonoscopy,alcohol consumption,prolonged fasting,inadequate bowel preparation,and excessive use of PEG-ELS are all high-risk factors for hypoglycemia.Constructing a predictive model can effectively predict these risks,providing reference for patient care and reducing the occurrence of hypoglycemia.

关 键 词：结肠镜检查 糖尿病 低血糖 风险预测模型 构建与评价 

分 类 号：R574[医药卫生—消化系统]