慢性荨麻疹患者焦虑状况发生的影响因素分析及nomogram预测模型构建

Analysis of factors influencing the occurrence of anxiety condition in patients with chronic urticaria and construction of nomogram prediction model

目的 探讨慢性荨麻疹患者焦虑状况发生的影响因素并构建nomogram预测模型。方法 选取200例慢性荨麻疹患者为研究对象,采用焦虑自评量表(SAS)对慢性荨麻疹患者焦虑情况进行评估,将SAS评分≥50分的患者纳入焦虑组(n=78),SAS评分<50分的患者纳入无焦虑组(n=122)。收集两组患者的临床资料,经logistic回归分析影响慢性荨麻疹患者焦虑状况发生的独立危险因素,R语言软件4.0“rms”包构建nomogram预测模型。结果 与无焦虑组比较,焦虑组女性比例较多、高中及以下比例较多、全身发病比例较多、病程较长、发作频率较高、风团持续时间较长,差异均有统计学意义(χ~2分别=13.26、8.72、6.75,t分别=13.66、6.85、7.45,P均<0.05)。病程、发作频率、风团持续时间的曲线下面积(AUC)分别为0.77、0.75、0.76,最佳截断值分别为2年、4次/周、4 h。性别(女性)、文化程度(高中及以下)、病程(>2年)、发作频率(>4次/周)、发病部位(全身)、风团持续时间(>4 h)是影响慢性荨麻疹患者焦虑状况发生的独立危险因素(OR分别=1.53、1.72、1.63、1.97、1.49、2.36,P均<0.05)。nomogram预测模型的校正曲线与理想曲线接近,C-index为0.82(95%CI 0.69~0.87);nomogram预测模型的风险阈值>0.18时,可提供临床净收益。结论 性别(女性)、文化程度(高中及以下)、病程(>2年)、发作频率(>4次/周)、发病部位(全身)、风团持续时间(>4 h)是影响慢性荨麻疹患者焦虑状况发生的独立危险因素,基于此构建的nomogram预测模型具有重要的临床参考意义。

Objective To investigate the factors influencing the occurrence of anxiety conditions in patients with chronic urticaria and to construct a nomogram prediction model.Methods A total of 200 patients with chronic urticaria were selected as the study objects.Self-rating anxiety scale(SAS) was used to evaluate the anxiety status of patients with chronic urticaria.Patients with SAS score ≥50 were included in the anxiety group(n=78).Patients with SAS scores <50 were included in the control group(n=122).The clinical data of the two groups were collected,and the independent risk factors affecting the anxiety of patients with chronic urticaria were analyzed by logistic regression.The nomogram prediction model was constructed with R language software 4.0 "rms" package.Results Compared with the control group,the proportion of women in the anxety group was higher,the proportion of high school and below was higher,the proportion of systemic disease was higher,the course of disease was longer,the frequency of attack was higher,and the duration of wind cluster was longer,with statistical significance(χ~2=13.26,8.72,6.75,t=13.66,6.85,7.45,P<0.05).The area under the curve(AUC) of disease course,attack frequency and wind cluster duration were 0.77,0.75 and 0.76,respectively,and the cut-off values were 2 years,4 times/week and 4 h,respectively.Gender(female),education level(high school or below),course of disease(>2 years) frequency of attack(>4 times/week),location of disease(whole body) and duration of wind cluster(>4 h) were independent risk factors affecting the occurrence of anxiety in patients with chronic urticaria(OR=1.53,1.72,1.63,1.97,1.49,2.36,P<0.05).The correction curve of the nomogram prediction model was close to the ideal curve with a C-index of 0.82(95%CI 0.69-0.87).When the risk threshold of nomogram prediction model is greater than 0.18,it can provide clinical net benefit.Conclusion Gender(female),education level(high school or below),course of disease(>2 years),frequency(>4 times/week),location of disease(whole body) and duration(>4 h) are independent risk factors for anxiety in patients with chronic urticaria.This nomogram model will be of great significance for clinical reference.