基于肝功能相关指标的有机磷中毒患者预后预测模型构建分析

Construction and analysis of prognostic model of patients with organophosphorus poisoning based on liver function index

目的探讨基于肝功能相关指标的有机磷中毒(AOPP)患者预后预测因素并构建预测模型。方法选取2019年1月—2022年6月本院收治的AOPP患者110例作为研究对象,根据预后情况分为存活组和死亡组。比较2组患者的临床资料,采用多因素logistic回归模型分析影响AOPP患者预后情况的相关因素,根据筛选出的影响因素构建列线图预测模型并验证模型效能。结果79例病情稳定出院或转普通病房为存活组,31例院内死亡为死亡组。2组总蛋白、白蛋白、谷草转氨酶、谷丙转氨酶、总胆红素对比差异有统计学意义(P<0.05);多因素logistic分析显示,总蛋白、白蛋白为AOPP患者预后的保护因素,谷草转氨酶、总胆红素为AOPP患者预后的危险因素(P<0.05),上述因素预测AOPP患者预后情况一致性指数(C-index)为0.829(95%CI:0.749~0.908),且校正曲线显示实测值与观察值基本相符。结论肝功能指标总蛋白、白蛋白、谷草转氨酶、总胆红素为AOPP患者预后的影响因素,由此构建的预后预测模型具有较高的应用价值。

Objective This paper aims to explore the prognostic factors of patients with organophosphorus poisoning(AOPP)based on liver function indexes and construct prediction model.Methods A total of 110 AOPP patients admitted to our hospital from January 2019 to June 2022 were selected as research objects and divided into survival group and death group according to the prognosis.The clinical data of the two groups of patients were compared.Multivariate logistic regression model was used to analyze the related factors affecting the prognosis of AOPP patients,and a column graph prediction model was constructed according to the selected influencing factors and the effectiveness of the model was verified.Results Seventy nine patients with stable condition discharged or transferred to the general ward were the survival group,thirty one patients diseased in hospital were the death group.There was statistical significance on the differences in total protein,albumin,aspartate aminotransferase,alanine aminotransferase and total bilirubin between the two groups(P<0.05).Multivariate logistic analysis showed that total protein and albumin were protective factors for the prognosis of AOPP patients,and asoxal aminotransferase and total bilirubin were prognostic risk factors for AOPP patients(P<0.05).The above factors predicted the prognostic consistency index(C-index)of AOPP patients was 0.829(95%CI:0.749-0.908),and the calibration curve showed that the measured value was basically consistent with the observed value.Conclusion Total protein,albumin,aspartate transaminase and total bilirubin are prognostic factors of AOPP patients,and the prognostic prediction model constructed by this method has high application value.