老年肺结核患者营养不良预测模型构建与验证  

Construction and validation of malnutrition prediction model for elderly tuberculosis patients

作　　者：邓小越 陈馨 赖珍 Deng Xiaoyue;Chen Xin;Lai Zhen(Tuberculosis Prevention and Control Institute of Shicheng County,Ganzhou,Jiangxi 342700,China)

机构地区：[1]江西省赣州市石城县结核病防治所,江西赣州342700

出　　处：《首都食品与医药》2025年第9期45-48,共4页Capital Food Medicine

摘　　要：目的 分析老年肺结核患者营养不良的影响因素,构建风险预测模型并验证。方法 回顾性选取2019年7月-2024年7月石城县结核病防治所收治的老年肺结核患者190例,并根据是否发生营养不良分为营养不良组和未发生营养不良组,收集其临床资料,分析发生营养不良的影响因素,并构建老年肺结核患者营养不良的风险预测模型,采用受试者工作特征曲线(ROC)评估模型预测价值。另根据建模组∶验证组7∶3的比例选取2022年7月-2024年7月石城县结核病防治所收治的老年肺结核患者82例为验证组,收集其临床资料对模型进行外部验证。结果 营养不良组患者90例(47.37%),未发生营养不良组患者100例(52.63%)。单因素及多因素分析结果显示,家庭人均月收入(OR=0.290,95%CI=0.157-0.534)、合并糖尿病(OR=4.193,95%CI=1.808-9.725)、肺结核病程(OR=2.165,95%CI=1.471-3.186)、耐药情况(OR=5.267,95%CI=1.994-13.915)、衰弱分级(OR=3.209,95%CI=1.811-5.683)、家庭功能(OR=5.775,95%CI=2.444-13.642)及合并焦虑抑郁(OR=6.847,95%CI=2.650-17.690)均为老年肺结核患者营养不良的独立影响因素(均P<0.05)。根据多因素分析结果构建模型公式为Logit(P)=-1.239×(家庭人均月收入)+1.433×(合并糖尿病)+0.772×(肺结核病程)+1.661×(耐药情况)+1.166×(衰弱分级)+1.753×(家庭功能)+1.924×(合并焦虑抑郁)-4.878。行ROC曲线分析,结果显示,建模组的ROC的AUC为0.875(95%CI=0.827-0.923,P<0.001),敏感度为0.822,特异度为0.800。验证组的ROC的AUC为0.887(95%CI=0.815-0.959,P<0.001)。结论 本研究构建的老年肺结核患者营养不良的预测模型效果较好,临床可据此识别高风险营养不良患者,并给予针对性干预措施以预防。Objective To analyze the influencing factors of malnutrition in elderly patients with pulmonary tuberculosis,build a risk prediction model and verify it.Methods 190 elderly patients with pulmonary tuberculosis admitted to the Tuberculosis Prevention and Control Institute in Shicheng County from July 2019 to July 2024 were retrospectively selected,and were divided into malnutrition group and non malnutrition group according to whether malnutrition occurred,collect their clinical data to analyze the influencing factors of malnutrition,and build a risk prediction model of malnutrition in elderly patients with pulmonary tuberculosis,and use the receiver operating characteristic curve(ROC)to evaluate the predictive value of the model.In addition,the elderly admitted to the Tuberculosis Prevention and Control Institute in Shicheng County from July 2022 to July 2024 were selected according to the 7∶3 ratio of the modeling group:the verification group 82 patients with pulmonary tuberculosis were used as the validation group.Their clinical data were collected for external validation of the model.Results There were 90 patients(47.37%)in the malnutrition group and 100 patients(52.63%)in the non malnutrition group.The results of univariate and multivariate analysis showed that the per capita monthly income of the family(OR=0.290,95%CI=0.157-0.534),combined diabetes(OR=4.193,95%CI=1.808-9.725),the course of pulmonary tuberculosis(OR=2.165,95%CI=1.471-3.186),drug resistance(OR=5.267,95%CI=1.994-13.915),weakness grade(OR=3.209,95%CI=1.811-5.683),family function(OR=5.775,95%CI=2.444-13.642),and combined anxiety and depression(OR=6.847,95%CI=2.650-17.690).The elderly pulmonary tuberculosis was the independent influencing factor of malnutrition(all P<0.05).According to the results of multi factor analysis,the model formula is Logit(P)=-1.239×(family average monthly income)+1.433×(combined with diabetes)+0.772×(pulmonary tuberculosis course)+1.661×(drug resistance)+1.166×(weakness grade)+1.753×(family function)+1.924×(comb

关 键 词：老年 肺结核 营养不良 预测模型 

分 类 号：R521[医药卫生—内科学]