基于列线图的糖尿病肾病患者血液透析期间体力活动不足预测模型的构建  

The Construction of a Prediction Model for Physical Activity Deficiency of Diabetic Nephropathy Patients During Hemodialysis Based on Nomogram

作　　者：李园珍 徐高玲 Li Yuanzhen;Xu Gaoling(People's Hospital of Leping City,Jiangxi Province,Leping Jiangxi 333300,China;Nanfeng County People's Hospital,Fuzhou City,Jiangxi Province,Fuzhou Jiangxi 344500,China)

机构地区：[1]江西省乐平市人民医院,江西乐平333300 [2]江西省抚州市南丰县人民医院,江西抚州344500

出　　处：《医疗装备》2025年第4期5-9,共5页Medical Equipment

基　　金：景德镇市科技计划项目(20232SFZ049)。

摘　　要：目的分析糖尿病肾病(DN)患者血液透析期间体力活动不足的危险因素,并构建预测模型。方法选取2021年1月至2024年6月医院收治的150例DN患者为研究对象,根据是否出现体力活动不足分为体力活动不足组与体力活动良好组。收集两组临床资料,采用单因素和多因素Logistic回归分析DN患者血液透析期间体力活动不足的危险因素;采用R Studio4.2.1软件构建列线图预测模型,并评估其预测效能。结果150例患者中43例出现体力活动不足,107例体力活动良好。单因素分析结果显示,年龄、透析龄、合并其他慢性病、出现透析相关症状、营养状况、自我效能感、社会支持是DN患者血液透析期间体力活动不足的影响因素(P<0.05)。多因素Logistic回归分析结果显示,透析龄、合并其他慢性病、出现透析相关症状、营养状况是DN患者血液透析期间体力活动不足的危险因素;自我效能感、社会支持是保护因素(P<0.05)。受试者工作特征(ROC)曲线下面积(AUC)为0.877,95%CI=0.823~0.931,灵敏度为0.720,特异度为0.953;Hosmer-Lemeshow检验结果显示,预测模型的拟合度较好(P<0.05);决策曲线显示模型临床适用度较好(P<0.05)。结论DN患者血液透析期间体力活动不足预测模型的预测效能良好,可用于预测DN患者血液透析期间的体力活动情况。Objective To analyze the risk factors of insufficient physical activity during hemodialysis in diabetic nephropathy(DN)patients and construct a predictive model.Methods With the selection of 150 DN patients admitted to the hospital from January 2021 to June 2024 as the research subjects,according to whether there was insufficient physical activity,they were divided into insufficient physical activity group and good physical activity group.With the collection of the clinical data of two groups,univariate and multivariate Logistic regression were used to analyze the risk factors for insufficient physical activity during hemodialysis in DN patients;The nomogram prediction model was constructed using R Studio4.2.1 software,and its predictive performance was evaluated.Results Among the 150 patients,43 had insufficient physical activity and 107 had good physical activity.The results of univariate analysis showed that age,dialysis age,comorbidities with other chronic diseases,occurrence of dialysis related symptoms,nutritional status,self-efficacy,and social support were the influencing factors of insufficient physical activity during hemodialysis in DN patients(P<0.05).The results of multiple logistic regression analysis showed that dialysis age,comorbidities with other chronic diseases,occurrence of dialysis related symptoms,and nutritional status were risk factors for insufficient physical activity during hemodialysis in DN patients;In addition,self-efficacy and social support were protective factors(P<0.05).The area(AUC)under receiver operating characteristic curve(ROC)was 0.877(95%CI=0.823~0.931),the sensitivity was 0.720,and the specificity was 0.953.Hosmer-Lemeshow test results showed that the prediction model had a good fitting degree(P<0.05).The decision curve showed that the model had good clinical applicability(P<0.05).Conclusion The predictive model of insufficient physical activity in DN patients during hemodialysis had good predictive efficacy,which was helpful to predict the physical activity status in DN

关 键 词：列线图 糖尿病肾病 血液透析 体力活动 

分 类 号：R459.5[医药卫生—治疗学]