胰源性门脉高压发生的危险因素分析及其Nomogram模型的建立

Analysis of risk factors of pancreatic portal hypertension and establishment of nomogram model

目的探究胰源性门脉高压发生的相关危险因素并建立风险预测模型。方法回顾性分析2004年1月至2022年1月于陆军军医大学第一附属医院收治的185例发生胰腺疾病患者的临床资料,根据是否发生门脉高压分为研究组(n=75)和对照组(n=110),分别采用单因素、相关性及多因素分析筛选出胰源性门脉高压发生的危险因素,并基于这些变量,利用Nomogram建立风险预测模型。结果在变量筛选中,结果显示吸烟、糖尿病史及病因是胰源性门脉高压的危险因素(OR=5.008、3.913、3.690),红细胞计数为保护性因素(OR=0.362)。基于变量筛选结果,构建胰源性门脉高压的Nomogram模型,模型的预测曲线下面积为0.789,且校准曲线具有良好的拟合度,说明该模型预测效果较好。决策曲线分析显示,当风险阈值在15%~85%之间时,能获得较好的净获益值,模型具有较高的临床适用性。结论Nomogram风险预测模型可有效地早期识别胰源性门脉高压的高危因素,早期干预,对疾病的预防具有重要意义。

Objective To explore the related risk factors of pancreatic portal hypertension(PPH)and then establish a risk prediction model.Methods The clinical data of 185 patients with pancreatic.diseases treated in the First Afiliated Hospital of Army Medical University from January 2004 to January 2022 were collected and analyzed retrospectively.They were divided into study group(n=75)and control group(n=110)according to the occurrence of portal hypertension.The risk factors of PPH were screened by univariate,correlation and multivariate analysis.Based on these variables,a risk prediction model was established by Nomogram.Results In variable screening,the results showed that smoking,history of diabetes and causes were risk factors for PPH(OR=5.008,3.913,3.690),and red blood cell count was a protective factor(OR=0.362).A nomogram model of PPH was constructed based on the results of variable screening.The area under the prediction curve of the model was 0.789,and the calibration curve had a good degree of fit,indicating that the model has a good prediction effect.Decision curve analysis showed that a better net gain value was obtained when the risk threshold is between 15%and 80%,and the model had high clinical applicability.Conclusion Our nomogram risk prediction model can ffectively identify the high risk factors of PPH and early intervention is of great significance for disease prevention.