原发性高血压视网膜静脉阻塞风险预警模型构建及验证  

Construction and validation of a risk early warning model for retinal vein occlusion in patients with primary hypertension

作　　者：高玮 艾力亚尔·艾尔肯 迪力夏提·多力坤 GAO Wei;ELIYAR Erkin;DILSHAT Dolkun(Department of Ophthalmology,the Second People′s Hospital of Kashgar Prefecture,Xinjiang Uygur Autonomous Region,Kashgar 844000,China)

机构地区：[1]新疆维吾尔自治区喀什地区第二人民医院眼科,新疆喀什844000

出　　处：《河北医科大学学报》2025年第4期459-464,共6页Journal of Hebei Medical University

基　　金：喀什地区应用技术研究与开发计划项目(KS2021083)。

摘　　要：目的构建原发性高血压视网膜静脉阻塞(retinal vein occlusion,RVO)风险预警模型并验证。方法从2021年1月—2022年12月喀什地区第二人民医院收治的原发性高血压患者1046例中筛查并发RVO患者32例为RVO组,另在剩余患者中随机选取50例为对照组。RVO患者根据黄斑中心视网膜厚度(central retinal thickness,CRT)是否>369μm分为高CRT组(n=10)和低CRT组(n=22),比较RVO组和对照组一般资料,比较高CRT组和低CRT组血浆血小板计数(blood platelet count,BPC)和血小板平均体积(mean platelet volume,MPV)水平,分析原发性高血压并发RVO的影响因素,根据Logistic回归分析结果构建原发性高血压并发RVO的风险预警模型并构建列线图,以原发性高血压并发RVO为阳性样本建立受试者工作特征(receiver operating characteristic,ROC)曲线,并经Hosmer-Lemeshow验证该风险预警模型的拟合度。结果RVO组BPC[(271.31±31.42)×10^(9)/L]、MPV[(9.52±0.88)fL]水平高于对照组[(256.38±28.45)×10^(9)/L、(7.85±0.73)fL,P<0.05]。高CRT组BPC[(288.31±34.42)×10^(9)/L]、MPV[(10.84±0.82)fL]水平高于低CRT组[(262.38±24.45)×10^(9)/L、(8.59±0.65)fL,P<0.05]。多因素Logistic回归分析结果显示,BPC、MPV是原发性高血压并发RVO的影响因素(P<0.05)。ROC曲线表明,BPC、MPV联合预测的AUC值(AUC=0.928,95%CI:0.876~0.981)明显优于BPC(AUC=0.740,95%CI:0.629~0.851)、MPV(AUC=0.919,95%CI:0.862~0.976)单独预测,且经Hosmer-Lemeshow验证该风险模型的拟合度良好。结论BPC、MPV与原发性高血压并发RVO和RVO的严重程度显著相关,且构建的风险模型拟合度良好。Objective To construct and validate a risk early warning model for retinal vein occlusion(RVO)in patients with primary hypertension.Methods From January 2021 to December 2022,32 patients with concurrent RVO were screened out from 1046 patients with primary hypertension admitted to the Second People′s Hospital of Kashgar Prefecture,and they were designated as the RVO group.Another 50 patients were randomly selected from the remaining patients as the control group.The RVO patients were divided into a high central retinal thickness(CRT)group(n=10)and a low CRT group(n=22)according to whether the CRT of the macular center was greater than 369μm.The general data between the RVO group and the control group were compared.The levels of blood platelet count(BPC)and mean platelet volume(MPV)in plasma were compared between the high CRT group and the low CRT group.The influencing factors of RVO complicated with primary hypertension were analyzed.According to the results of Logistic regression analysis,a risk early warning model for RVO complicated with primary hypertension was constructed,and a nomogram was drawn.Using RVO complicated with primary hypertension as the positive sample,a receiver operating characteristic(ROC)curve was established,and the goodness of fit of this risk early warning model was verified by Hosmer-Lemeshow test.Results The levels of BPC[(271.31±31.42)×10^(9)/L]and MPV[(9.52±0.88)fL]in the RVO group were higher than those in the control group[(256.38±28.45)×10^(9)/L,(7.85±0.73)fL,P<0.05].The levels of BPC[(288.31±34.42)×10^(9)/L]and MPV[(10.84±0.82)fL]in the high CRT group were higher than those in the low CRT group[(262.38±24.45)×10^(9)/L,(8.59±0.65)fL,P<0.05].The results of multivariate Logistic regression analysis showed that BPC and MPV were the influencing factors of RVO complicated with primary hypertension(P<0.05).The ROC curve indicated that the area under the curve(AUC)value of the combined prediction of BPC and MPV(AUC=0.928,95%CI:0.876-0.981)was significantly better than the

关 键 词：原发性高血压 视网膜静脉闭塞 血小板计数 平均血小板体积 

分 类 号：R544.1[医药卫生—心血管疾病] R774.1[医药卫生—内科学]