基于床旁简易指标构建急性胰腺炎继发感染性胰腺坏死的Nomogram模型  

Construction of a nomogram to predict infectious pancreatic necrosis secondary to acute pancreatitis based on simple bedside indicators

作　　者：杨钲娟 陈启宁 吴仙 YANG Zheng-juan;CHEN Qi-ning;WU Xian

机构地区：[1]莆田学院附属医院,福建莆田351100

出　　处：《中国疗养医学》2025年第5期98-103,共6页Chinese Journal of Convalescent Medicine

摘　　要：目的构建基于床旁简易指标的急性胰腺炎(AP)继发感染性胰腺坏死(IPN)的Nomogram模型,并探讨模型预测价值。方法回顾性选取2022年10月至2023年12月莆田学院附属医院收治的154例AP患者为研究对象,做建模组,另按7∶3分配比选取2024年1月至9月AP患者66例为验证组。采用单因素分析和二元Logistic回归分析筛选出AP患者继发IPN的相关独立影响因素,并基于独立影响因素建立Nomogram预测模型。结果经二元Logistic回归分析结果显示,床旁易获取指标机械通气、体温、心率、呼吸频率、合并低氧血症、肠鸣音微弱、肠鸣音消失、肺部听诊音、腹膜刺激征是AP患者继发IPN的独立影响因素(均P<0.05);基于上述独立影响因素构建Nomogram预测模型,模型拟合度良好(P>0.05),建模组ROC曲线下面积为0.962,验证组ROC曲线下面积为0.917。结论基于机械通气、肠鸣音、肺部听诊音等床旁简易指标构建的Nomogram预测模型,预测效果良好并且验证具有一致性,易得易测、简单快捷。Objective To establish a nomogram to predict infectious pancreatic necrosis(IPN)secondary to acute pancreatitis(AP)based on simple bedside indicators,and to validate its performance.Methods A total of 154 AP patients admitted to the Affiliated Hospital of Putian University from October 2022 to December 2023 were retrospectively included in the modeling group,and 66 AP patients from January to September 2024 were selected as the verification group according to the 7∶3 allocation ratio.Univariate analysis and binary Logistic regression analysis were used to screen out the independent influencing factors for IPN secondary to AP.A nomogram was established based on the independent influencing factors.Results The results of binary Logistic regression analysis showed that mechanical ventilation,body temperature,heart rate,respiratory rate,combined hypoxemia,weak bowel sound,disappearance of bowel sound,pulmonary auscultation sound,and peritoneal irritation were independent influencing factors for IPN secondary to AP(all P<0.05).Based on the above independent factors,a nomogram was established,and the model had a good fit(P>0.05),with the area under the receiver operating characteristic(ROC)curve(AUC)of 0.962 in the modeling group and 0.917 in the verification group.Conclusion A nomogram incorporating simple indicators such as mechanical ventilation,bowel sounds,and lung stethoscope is constructed,and validated for its good predictive value,and high consistency.It is easy to obtain and measure,simple and fast,and has clinical application value.

关 键 词：急性胰腺炎 感染性胰腺坏死 床旁简易指标 预测模型 

分 类 号：R576[医药卫生—消化系统]