维持性血液透析患者合并糖尿病的危险因素分析及预测模型构建

Analysis of risk factors and construction of predictive models for combined diabetes in maintenance hemodialysis patients

目的探究维持性血液透析患者合并糖尿病的危险因素并构建预测模型。方法于2021年6月至9月对武汉大学人民医院和武汉大学中南医院血透析室的227例维持性血液透析患者进行调查,根据是否合并糖尿病分为维持性血液透析合并糖尿病组91例和维持性血液透析未合并糖尿病组136例。采用logistic回归分析危险因素,并根据结果建立预测模型。结果两组婚姻状况、活动能力、睡眠质量、Kt/V、前白蛋白、体重指数(BMI)、脉压差、维生素B_(12)及年龄比较,差异有统计学意义(P<0.05)。logistic回归结果显示,活动能力、BMI、睡眠质量、Kt/V、前白蛋白、脉压差是维持性血液透析患者合并糖尿病的影响因素(P<0.05)。结论活动能力、BMI、睡眠质量、Kt/V、前白蛋白、脉压差是维持性血液透析患者合并糖尿病的影响因素,预测模型有助于早期识别维持性血液透析合并糖尿病的患者。

Objective To investigate the risk factors and to construct a predictive model for comorbid diabetes in maintenance hemodialysis patients.Methods From June to September 2021,a total of 227 maintenance hemodialysis patients in the hemodialysis units of the Remin Hospital of Wuhan University and the Central South Hospital of Wuhan University were investigated,and they were divided into 91 cases in the maintenance hemodialysis with diabetes group and 136 cases in the maintenance hemodialysis without diabetes group according to whether they had comorbid diabetes.Risk factors were analyzed using logistic regression equations,and prediction models were developed based on the results.Results The differences in marital status,mobility,sleep quality,Kt/V,prealbumin,body mass index(BMI),pulse pressure difference,vitamin B_(12),and age were statistically significant when comparing the two groups(P<0.05).The logistic regression results showed that mobility,BMI,sleep quality,Kt/V,prealbumin,and pulse pressure difference were influential factors for combined diabetes in patients with maintenance hemodialysis(P<0.05).Conclusion Mobility,BMI,sleep quality,Kt/V,prealbumin,and pulse pressure difference are influential factors in maintenance hemodialysis patients with comorbid diabetes mellitus,and predictive models can help identify patients with comorbid diabetes mellitus on maintenance hemodialysis early.