基于随机森林模型和Logistic回归模型的结核性脑膜炎患者预后影响因素的分析

Analysis of Prognosis Influencing Factors in Patients with Tuberculous Meningitis Based on Random Forest Model and Logistic Regression Model

目的:采用随机森林模型和Logistic回归模型分析结核性脑膜炎(tuberculous meningitis,TBM)患者预后的影响因素,为TBM患者的治疗和预后判断提供依据。方法:采集2016年1月—2021年1月苏州市第五人民医院收治的107例TBM患者的病历资料,根据患者预后情况将其分为预后良好组(79例)和预后不良组(28例),采用随机森林模型和Logistic回归模型分析TBM患者预后的影响因素。结果:随机森林模型分析结果显示,脑脊液蛋白含量、脑脊液腺苷脱氨酶水平、发热、意识障碍、瘫痪、病程、性别、治疗史、居住地、复视或视力下降为评分较高的影响因素;Logistic回归模型分析结果显示,脑脊液蛋白含量高、有发热、存在意识障碍与TBM患者预后不良具有相关性(P<0.05)。结论:基于随机森林模型和Logistic回归模型的分析显示,脑脊液蛋白含量、发热和意识障碍与TBM患者的预后密切相关,是患者预后不良的独立危险因素,临床应高度重视对患者这些因素的管控,减少患者预后不良的发生。

Objective:To analyze the prognosis influencing factors of patients with tuberculous meningitis(TBM)by random forest model and logistic regression model,and provide a basis for the treatment and prognosis judgment of patients with TBM.Methods:The medical records of 107 patients with TBM who were admitted to the Fifth People’s Hospital of Suzhou from January 2016 to January 2021 were collected,the patients were divided into a good prognosis group(79 cases)and a poor prognosis group(28 cases)according to the prognosis,and the prognosis influencing factors of patients with TBM were analyzed by random forest model and logistic regression model.Results:The analysis results of random forest model showed that cerebrospinal fluid protein content,cerebrospinal fluid adenosine deaminase level,fever,impaired consciousness,paralysis,disease duration,gender,treatment history,place of residence,diplopia or decreased visual acuity were the influencing factors with high scores.The analysis results of logistic regression model showed that high cerebrospinal fluid protein content,fever and impaired consciousness were correlated with poor prognosis in patients with TBM(P<0.05).Conclusion:The analysis based on random forest model and logistic regression model showed that cerebrospinal fluid protein content,fever and impaired consciousness were closely related to the prognosis of patients with TBM and were independent risk factors for poor prognosis of patients,so great attention should be paid to clinical management and control of such factors in patients to reduce poor prognosis of patients.