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脓毒症并发急性肺损伤风险列线图模型的建立及验证
引用本文:余校宇,龙江超,黄明海. 脓毒症并发急性肺损伤风险列线图模型的建立及验证[J]. 中南医学科学杂志, 2024, 0(4): 559-562
作者姓名:余校宇  龙江超  黄明海
作者单位:四川省人民医院医疗集团 东篱医院,四川成都601000;大方县人民医院,贵州毕节551669
基金项目:四川省科技计划项目(2019YFQ0003)
摘    要:目的建立并验证脓毒症并发急性肺损伤(ALI)风险的列线图模型。 方法选取257例脓毒症患者为建模组,另以7∶3的比例收集同期110例脓毒症患者为验证组。两组均根据是否并发ALI分为ALI组与无ALI组。Logistic回归分析脓毒症患者并发ALI的影响因素,R软件构建脓毒症并发ALI风险的列线图模型并进行验证。 结果建模组ALI发生率为33.85%,验证组ALI发生率为31.82%。肺部感染(OR=16.505)、降钙素原(PCT,OR=2.640)、肿瘤坏死因子-α(TNF-α,OR=1.098)、氧合指数(OR=0.867)、APACHEⅡ评分(OR=1.750)是脓毒症并发ALI的影响因素(P<0.05)。基于以上5个指标构建列线图预测模型,建模组和验证组列线图预测ALI发生风险的AUC分别为0.858、0.877,H-L检验显示一致性较好,校准曲线预测概率与实际概率接近,提示模型预测ALI发生风险具有良好准确度。 结论脓毒症并发ALI影响因素包括APACHEⅡ评分、肺部感染、PCT、TNF-α、氧合指数,据此构建ALI发生风险的列线图模型预测价值较好,可为个体化预防脓毒症患者并发ALI提供参考。

关 键 词:脓毒症   急性肺损伤   列线图模型   影响因素
收稿时间:2023-12-15
修稿时间:2024-03-20

Establishment and validation of a risk line chart model for sepsis complicated with acute lung injury
YU Xiaoyu,LONG Jiangchao,HUANG Minghai. Establishment and validation of a risk line chart model for sepsis complicated with acute lung injury[J]. Journal of Medical Sciencein Central Sauh China, 2024, 0(4): 559-562
Authors:YU Xiaoyu  LONG Jiangchao  HUANG Minghai
Affiliation:Sichuan Provincial People''s Hospital Medical Group Dongli Hospital, Chengdu 601000, Sichuan, China;Dafang People''s Hospital, Bijie 551669, Guizhou, China
Abstract:AimTo establish and validate an column chart model for the risk of sepsis complicated with acute lung injury (ALI) in sepsis. MethodsA total of 257 patients with sepsis were selected as the modeling group, and 110 patients with sepsis during the same period were collected as the validation group in a 7∶3 ratio. The two groups were divided into an ALI group and a non-ALI group according to whether they had concurrent ALI. Logistic regression model was applied to analyze the influencing factors of ALI in sepsis patients, R software was applied to construct a column chart model for the risk of sepsis complicated with ALI, and validation was conducted. ResultsThe incidence rate in the modeling group was 33.85%, while the incidence rate in the validation group was 31.82%. The pulmonary infection (OR=16.505), procalcitonin (PCT, OR=2.640), tumor necrosis factor-α (TNF-α, OR=1.098), oxygenation index (OR=0.867), and APACHEⅡscore (OR=1.750) were the influencing factors of sepsis complicated with ALI (P<0.05). Based on the above 5 indicators, a column chart prediction model was constructed. The AUC of the column charts for predicting the risk of ALI occurrence in the modeling group and validation group were 0.858 and 0.877, respectively. The H-L test showed good consistency, and the predicted probability of the calibration curve was close to the actual probability, indicating that the model has good accuracy in predicting the risk of ALI occurrence. ConclusionThe influencing factors of sepsis complicated with ALI include APACHEⅡscore, pulmonary infection, PCT, TNF-α, and oxygenation index. Based on this, the constructed column chart model for predicting the risk of ALI has good predictive value and can provide reference for individualized prevention of ALI in sepsis patients.
Keywords:sepsis   acute lung injury   column chart model   influence factor
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