职业性尘肺病患者应激性溃疡发生影响因素及预警模型  

Identification of influencing factors of stress ulcer in patients with occupational pneumoconiosis and development of an early warning model

作　　者：陈颖 吴国庆 谭俊良 Ying Chen;Guo-Qing Wu;Jun-Liang Tan(Department of Internal Medicine,Huzhou Shushan Geriatric Hospital Co.,Ltd,Huzhou 313000,Zhejiang Province,China)

机构地区：[1]湖州蜀山老年医院有限公司内科,浙江省湖州市313000

出　　处：《世界华人消化杂志》2025年第3期183-191,共9页World Chinese Journal of Digestology

摘　　要：背景职业性尘肺病并发应激性溃疡尚缺少特异性治疗方案,不恰当治疗可增加不良事件,影响疾病预后.本研究拟通过分析职业性尘肺病并发应激性溃疡影响因素,构建预警模型,以期指导临床治疗决策.目的探讨职业性尘肺病患者应激性溃疡发生影响因素及预警模型.方法前瞻性选取2021-10/2024-10湖州蜀山老年医院收治的58例职业性尘肺病并发应激性溃疡患者作为观察组,另按照1:2配对原则选取116例单纯职业性尘肺病患者作为对照组.统计两组一般资料、生化指标,采用Lasso-Logistic回归方程分析应激性溃疡发生影响因素,采用R软件构建应激性溃疡列线图预警模型,采用受试者工作特征曲线、校准曲线、决策曲线分析列线图预警模型诊断效能.结果(1)观察组血清胃动素(motilin,MLT)、热休克蛋白70(heat shock protein 70,HSP70)、肿瘤坏死因子-α、C反应蛋白水平及疾病分期3期、饮酒、抑郁/焦虑、幽门螺杆菌(Helicobacter pylori,H.pylori)阳性所占比例均高于对照组(P<0.05);(2)MLT、HSP70、疾病分期、抑郁/焦虑、H.pylori阳性是应激性溃疡发生的高危因素(P<0.05);(3)列线图预警模型诊断应激性溃疡的曲线下面积为0.792(95%CI:0.718-0.866),诊断结果与实际结果有较好拟合性,当阈概率为15%-80%时,患者的净获益率较高.结论基于MLT、HSP70、疾病分期、抑郁/焦虑、H.pylori阳性构建的列线图预警模型可有效诊断职业性尘肺病患者应激性溃疡发生风险,有助于优化治疗措施,控制病情进展.BACKGROUND There is still a lack of specific treatment options for stress ulcer caused by occupational pneumoconiosis.Inappropriate treatment can increase adverse events and affect the prognosis of patients.This study intended to identify the influencing factors of stress ulcer caused by occupational pneumoconiosis and develop an early warning model to guide clinical treatment decisions.AIM To identify the influencing factors of stress ulcer in patients with occupational pneumoconiosis and to develop an early warning model for this condition.METHODS A prospective study was conducted,in which 58 patients with occupational pneumoconiosis complicated with stress ulcer admitted to Huzhou Shushan Geriatric Hospital from October 2021 to October 2024 were selected as an observation group,and another 116 patients with simple occupational pneumoconiosis were selected as a control group at a 1:2 ratio.General information and biochemical indicators were collected for both groups.The Lasso-Logistic regression equation was used to analyze the influencing factors of stress ulcer.R was used to construct a nomogram-based stress ulcer warning model.Receiver operating characteristic curve,calibration curve,and decision curve analysis were used to analyze the diagnostic efficacy of the warning model.RESULTS The levels of serum motilin(MLT),heat shock protein 70(HSP70),tumor necrosis factor-α,and C-reactive protein,as well as the proportions of patients with stage 3 disease,alcohol consumption,depression/anxiety,and Helicobacter pylori(H.pylori)positivity in the observation group were higher than those of the control group(P<0.05).MLT,HSP70,disease stage,depression/anxiety,and H.pylori positivity were high-risk factors for the occurrence of stress ulcer(P<0.05).The area under the curve of the nomogram warning model for diagnosing stress ulcer was 0.792(95%confidence interval:0.718-0.866),and the diagnostic results had a good fit with the actual results.When the threshold probability was 15%-80%,the net benefit rate of patients was

关 键 词：职业性尘肺病 应激性溃疡 影响因素 预警模型 

分 类 号：R13[医药卫生—劳动卫生]