基于证素原理构建高危肺结节预测模型  

Construction of A High-risk Pulmonary Nodule Predictive Model Based on Syndrome Elements

作　　者：叶金连[1,2,3] 高心宇 苏泳鑫 谭钟 李灿东[1] YE Jinlian;GAO Xinyu;SU Yongxin;TAN Zhong;LI Candong(Research Base of Traditional Chinese Medicine Syndrome,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China;The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350003,China;Fujian Provincial Clinical Medical Research Center for Early-stage Lung Cancer Integrated with Traditional Chinese and Western Medicine Diagnosis and Treatment,Fuzhou 350003,China)

机构地区：[1]福建中医药大学中医证研究基地,福州350122 [2]福建中医药大学附属第二人民医院,福州350003 [3]福建省早期肺癌中西医结合诊疗临床医学研究中心,福州350003

出　　处：《世界中医药》2025年第4期633-638,647,共7页World Chinese Medicine

基　　金：国家自然科学基金海峡联合基金项目(U22A20376);福建中医药大学2023年度基础类学科科研提升计划项目(XJC2023006)。

摘　　要：目的:构建高危肺结节的预测模型,为肺结节风险分层管理提供依据。方法:选取2022年6月至2023年12月福建中医药大学附属第二人民医院体检人群中CT发现的非高危肺结节患者460例作为研究对象。纳入时和6个月至1年内进行中医四诊信息采集和影像CT复查,观察进展组和稳定组影响因素,建立结节进展的预测模型。结果:460例患者中进展组22例,稳定组438例,结节进展为高危结节的预测模型,Logit(P)=-5.992+2.113*(老年段)+1.430*(证素肺)+1.674*(证素阳虚)+1.871*(证素热)+2.127*(部分实性结节)+1.941*(肿瘤家族史)+1.609*(糖尿病)。结论:非高危肺结节是否进展成高危结节可能的影响因素为:老年段、肿瘤家族史、糖尿病、部分实性结节、肺、阳虚、热,可作为临床判定结节是否进展的依据。Objective:To construct a predictive model for high-risk pulmonary nodules,providing a basis for the risk stratification management of pulmonary nodules.Methods:A total of 460 patients with non-high-risk pulmonary nodules detected by CT between June 2022 and December 2023 at the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine were selected.Traditional Chinese medicine(TCM)information was collected at the time of inclusion and followed up with CT reexamination 6 months to 1 year later.Factors influencing progression in the progression group and stable group were observed,and a predictive model for nodule progression was established.Results:Among the 460 patients,22 were in the progression group and 438 in the stable group.The predictive model for the progression of nodules to high-risk status was Logit(P)=-5.992+2.113*(elderly group)+1.430*(lung syndrome)+1.674*(yang deficiency syndrome)+1.871*(heat syndrome)+2.127*(partially solid nodules)+1.941*(family history of cancer)+1.609*(diabetes).Conclusion:The potential influencing factors for the progression of non-high-risk pulmonary nodules to high-risk status include elderly age,family history of cancer,diabetes,partially solid nodules,lung syndrome,yang deficiency syndrome,and heat syndrome.These factors can serve as a clinical basis for determining whether a nodule progresses.

关 键 词：肺结节 高危 证素辨证 预测模型 临床研究 进展 糖尿病 肿瘤家族史 

分 类 号：R259[医药卫生—中西医结合]