慢性肾功能衰竭维持性血透患者运动恐惧发生的影响因素及列线图风险预测模型的构建

Influencing factors and establishment of nomogram risk prediction model for occurrence of exercise fear in patients with chronic renal failure receiving maintenance hemodialysis

目的探讨慢性肾功能衰竭维持性血透(MHD)患者运动恐惧发生的影响因素,并构建列线图风险预测模型。方法采取便利抽样法选取296例慢性肾功能衰竭MHD患者进行调查,根据调查时间将其分为建模组(207例)和验证组(89例),分析建模组运动恐惧发生的危险因素,绘制列线图风险预测模型,并利用验证组数据对该模型进行验证。结果年龄≥60岁、体质指数≥24 kg/m^(2)、透析龄≥3年、合并症个数≥2个、感知运动益处量表得分低、感知运动障碍量表得分高和简体中文版创伤后成长评定量表(C-PTGI)得分低是慢性肾功能衰竭MHD患者运动恐惧发生的危险因素(P<0.05)。根据上述危险因素构建的列线图风险预测模型具有良好的区分度、预测精准度和较高的净获益值。结论年龄≥60岁、体质指数≥24 kg/m^(2)、透析龄≥3年、合并症个数≥2个、感知运动益处量表得分低、感知运动障碍量表得分高和C-PTGI得分低是导致慢性肾功能衰竭MHD患者运动恐惧发生的危险因素,基于上述危险因素构建的列线图风险预测模型具有良好的区分度、预测精准度和较高的净获益值。临床上可根据慢性肾功能衰竭MHD患者情况早期、精准地识别其运动恐惧的发生风险,并通过采取相关措施来降低患者产生运动恐惧的概率。

Objective To explore the influencing factors for occurrence of exercise fear in patients with chronic renal failure receiving maintenance hemodialysis(MHD),and to establish a nomogram risk prediction model.Methods A total of 296 MHD patients with chronic renal failure were selected for investigation by employing the convenience sampling method,and they were divided into modeling group(207 cases)or validation group(89 cases)according to investigation time.The risk factors for occurrence of exercise fear in the modeling group were analyzed,the nomogram risk prediction model was drawn,and this model was validated by using the data from the validation group.Results Age≥60 years old,body mass index≥24 kg/m^(2),dialysis age≥3 years,categories of complications≥2,a low perceived exercise benefits scale score,a high perceived dyskinesia scale score,and a low Chinese Post-Traumatic Growth Inventory(C-PTGI)score were the risk factors for occurrence of exercise fear in MHD patients with chronic renal failure(P<0.05).The nomogram risk prediction model established based on aforementioned risk factors exerted favorable discrimination,predictive accuracy,and relatively high net benefit value.Conclusion Age≥60 years old,body mass index≥24 kg/m^(2),dialysis age≥3 years,categories of complications≥2,a low perceived exercise benefits scale score,a high perceived dyskinesia scale score,and a low C-PTGI score are the risk factors contributed to occurrence of exercise fear in MHD patients with chronic renal failure,and the nomogram risk prediction model established based on risk factors as above exerts favorable discrimination,predictive accuracy,and relatively high net benefit value.Clinically,the occurrence risk of exercise fear can be identified early and accurately according to the situation of MHD patients with chronic renal failure,and relevant measures can be taken to decrease the probability of developing exercise fear in patients.