溃疡性结肠炎并发坏疽性脓皮病患者发生营养风险的因素及预测模型  

Risk factors for malnutrition in ulcerative colitis complicated with pyoderma gangrenosum and construction of a lasso regression-based prediction model

作　　者：申琳[1] 宋翠豪 王聪敏 高西 安俊红[4] 李承新[1] 梁斌 李霞[6] SHEN Lin;SONG Cuihao;WANG Congmin;GAO Xi;AN Junhong;LI Chengxin;LIANG Bin;LI Xia(Department of Dermatology,First Medical Center of PLA General Hospital,Beijing 100853,China;Department of Dermatology,Seventh Medical Center of PLA General Hospital,Beijing 100010,China;Department of Traditional Chinese Medicine,University Town Hospital Affiliated to Chongqing Medical University,Chongqing 401331,China;Department of Plastic Surgery,First Hospital of Shanxi Medical University,Taiyuan 030032,China;Department of Dermatology,PLA Air Force Medical Center,Beijing 100142,China;Department of Rehabilitation,First Medical Center of PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心皮肤科,北京100853 [2]解放军总医院第七医学中心皮肤科,北京100010 [3]重庆医科大学附属大学城医院中医科,重庆401331 [4]山西医科大学第一医院整形科,山西太原030032 [5]解放军空军特色医学中心皮肤科,北京100142 [6]解放军总医院第一医学中心康复科,北京100853

出　　处：《南方医科大学学报》2025年第3期514-521,共8页Journal of Southern Medical University

基　　金：国家自然科学基金(82273530)。

摘　　要：目的探索溃疡性结肠炎伴发坏疽性脓皮病患者发生营养不良的风险因素,并建立本类患者营养风险预测模型。方法纳入2019~2024年277例溃疡性结肠炎伴坏疽性脓皮病患者为研究对象,根据是否发生营养不良分为不良组(n=185)和良好组(n=92)。比较两组患者一般人口学、生活饮食习惯、疾病相关资料共25项潜在相关因素的差异。采用Lasso回归筛选危险因素,建立列线图模型并验证模型预测性能。结果不良组与良好组间性别、年龄、文化程度、BMI指数、居住地、病程、SAS语评分等共21个指标存在差异(P<0.05)。Lasso回归分析发现溃疡性结肠炎病程、溃疡性结肠炎活动度、坏疽性脓皮病病程、合并慢性病数量、SAS评分、睡眠质量6个因素与本类患者营养不良相关性较大。基于上述6个因素建立列线图预测模型,预测该类患者营养不良AUC(95%CI)=0.992(0.984~1.000),对14例患者的应用显示准确率100%。结论溃疡性结肠炎病程、结肠炎活动度、坏疽性脓皮病病程、合并慢性病数量、焦虑程度、睡眠质量与溃疡性结肠炎伴发坏疽性脓皮病患者营养不良相关性较大,基于上述6个因素建立列线图预测模型有较高临床应用价值。Objective To explore the risk factors for malnutrition in patients with ulcerative colitis complicated with pyoderma gangrenosum and establish a nutritional risk prediction model for these patients.Methods A total of 277 patients with ulcerative colitis complicated with pyoderma gangrenosum treated from 2019 to 2024 were divided into malnutrition group(n=185)and normal nutrition group(n=92)according to whether malnutrition occurred.The data of 25 potential related factors pertaining to general demography,living and eating habits,and disease-related data were compared between the two groups.Lasso regression was used to screen the risk factors,and a nomogram model was established based on the screened factors and its prediction performance was assessed.Results The patients in the malnutrition group and normal nutrition group showed significant differences in 21 factors including gender,age,education level,BMI,place of residence,course of disease,and SAS language score(P<0.05).Lasso regression analysis identified 6 factors associated with malnutrition in these patients,namely the duration of ulcerative colitis,activity of ulcerative colitis,duration of pyoderma gangrenosum,number of chronic diseases,SAS score,and sleep quality.The nomogram prediction model established based on these 6 factors had an AUC of 0.992(95%CI:0.984-1.000)for predicting malnutrition in these patients,and its application in 14 clinical cases achieved an accuracy rate of 100%.Conclusion The duration of ulcerative colitis,activity of colitis,duration of pyoderma gangrenosum,number of chronic diseases,anxiety,and sleep quality are closely related with malnutrition in patients with ulcerative colitis complicated by pyoderma gangrenosum,and the nomogram prediction model based on these factors can provide assistance for predicting malnutrition in these patients.

关 键 词：溃疡性结肠炎 坏疽性脓皮病 营养风险 预测模型 

分 类 号：R574.62[医药卫生—消化系统] R753[医药卫生—内科学]