良性前列腺增生并发逼尿肌活动低下的危险因素分析及风险列线图预测模型的建立

Analysis of risk factors of benign prostatic hyperplasia complicated with detrusor underactivity and establishment of risk nomogram prediction model

目的探讨良性前列腺增生(BPH)并发逼尿肌活动低下(DU)的危险因素,并构建列线图预测模型。方法选取2019年6月—2021年6月于广州市中西医结合医院就诊的202例BPH患者作为研究对象,收集患者的临床资料,使用logistic回归分析BPH患者并发DU的危险因素,并建立列线图预测模型。结果年龄≥60岁、糖尿病史、肾积水史、国际前列腺症状评分(IPSS)高、前列腺体积(PV)大和前列腺特异性抗原(PSA)水平高是BPH患者并发DU的独立危险因素(P<0.05)。依此建立预测BPH患者并发DU的列线图风险模型,模型验证结果显示C-index为0.807,校正曲线趋近于理想曲线,ROC的曲线下面积(AUC)为0.790(95%CI:0.767~0.831),表明该模型具有良好的预测能力。结论BPH并发DU的危险因素包括年龄≥60岁、糖尿病史、肾积水史、IPSS评分高、PV大和PSA水平高,据此构建的列线图模型能准确预测BPH患者并发DU的风险概率。

Objective To investigate the risk factors of detrusor underactivity(DU)in benign prostatic hyperplasia(BPH),and to construct a nomogram prediction model.Methods From June 2019 to June 2021,202 patients with BPH treated in Guangzhou Integrated Traditional Chinese and Western Medicine Hospital were selected as the research objects.The clinical data of patients were collected.The risk factors of BPH patients complicated with DU were analyzed by logistic regression,and the nomogram prediction model was established.Results Age over 60 years,history of diabetes,history of hydronephrosis,high IPSS score,large PV and high PSA level were independent risk factors for DU in BPH patients(P<0.05).A nomogram risk model for predicting DU in patients with BPH was established.The model verification results showed that the C-index was 0.807.The correction curve was close to the ideal curve,and the AUC of ROC curve was 0.790(95%CI:0.767-0.831),indicating that the model has good prediction ability.Conclusion Risk factors of DU in BPH patients include age over 60 years,diabetes history,hydronephrosis history,high IPSS score,high PV and high PSA level.Based on this,the nomogram model can accurately predict the risk probability of DU in BPH patients.