寻常型银屑病复发的高危因素及预测模型的建立

Risk factors and risk prediction models for disease recurrence in patients with psoriasis vulgaris

目的探讨寻常型银屑病患者疾病复发的危险因素及其风险预测模型的构建。方法回顾性分析2020年1月~2022年1月河北省皮肤病防治院收治的150例寻常型银屑病患者,根据随访疾病复发情况分为复发组(n=95)和未复发组(n=55)。对两组寻常型银屑病患者疾病复发相关因素进行单因素分析,根据单因素分析结果对有统计学意义的危险因素再进行logistic回归分析,筛查寻常型银屑病复发可能的独立影响因素;采用回归系数建立常型银屑病复发的预测模型;绘制受试者工作特征(receiver operating characteristic,ROC)曲线,以曲线下面积(area under curve,AUC)对寻常型银屑病复发模型效能进行评价。结果单因素分析结果显示,年龄≥45岁、家族银屑病史、吸烟、饮酒、感染、睡眠障碍、受潮、不规范用药、外伤、紧张情绪、内分泌代谢紊乱对寻常型银屑病复发有显著影响(P<0.05);年龄≥45岁、家族银屑病史、吸烟、饮酒、感染、睡眠障碍、受潮、不规范用药、外伤、紧张情绪、代谢性疾病是寻常型银屑病复发的独立影响因素(P<0.001)。年龄≥45岁、家族银屑病史、吸烟、饮酒、感染、睡眠障碍、受潮、不规范用药、外伤、紧张情绪、代谢性疾病与寻常型银屑病复发均呈显著正相关(P<0.05)。寻常型银屑病复发预测模型:h(t,X)=h0(t)exp(0.836X1+1.334X2+0.326X3+1.401X4+1.295X5+1.533X6+0.457X7+1.383X8+1.567X9+1.412X10+1.523X11)。寻常型银屑病复发预测模型效能的ROC曲线分析显示,AUC=0.867(95%CI=0.714~0.812,P<0.05),最佳预测截断值为0.665,敏感度为73.65%,特异度为93.87。结论年龄≥45岁、家族银屑病史、吸烟、饮酒、感染、睡眠障碍、受潮、不规范用药、外伤、紧张情绪、代谢性疾病等均会导致寻常型银屑病患者复发。

Objective To explore the risk factors of disease recurrence in patients with psoriasis vulgaris and establish a risk prediction model.Methods Clinical data of 150 patients with psoriasis vulgaris admitted to our hospital from January 2020 to January 2022 were retrospectively analyzed,and they were divided into relapse group(n=95)and non-recurrence group(n=55)according to follow-up disease recurrence.A univariate analysis was performed on the factors related to disease recurrence in the two groups of psoriasis vulgaris patients.Logistic regression analysis was performed on the risk factors with statistical significance according to the result of univariate analysis,and the possible independent influencing factors of psoriasis vulgaris recurrence were screened.The regression coefficient was used to establish the prediction model of normal psoriasis recurrence.The receiver operating characteristic(ROC)curve was drawn to evaluate the effectiveness of the psoriasis vulgaris recurrence model with the area under curve(AUC).Results The result of univariate analysis showed that age≥45 years,family history of psoriasis,smoking,drinking,infection,sleep disorders,dampness,irregular medication,trauma,nervous mood,endocrine and metabolic disorders had significant effects on the recurrence of psoriasis vulgaris(P<0.05).Age≥45 years,family history of psoriasis,smoking,drinking,infection,sleep disorder,damp,irregular drug use,trauma,stress,endocrine and metabolic disorders were independent factors for the recurrence of psoriasis vulgare(P<0.001).Age≥45 years,family history of psoriasis,smoking,drinking,infection,sleep disorders,dampness,irregular medication,trauma,nervous mood,endocrine and metabolic disorders were significantly positively correlated with the recurrence of psoriasis vulgaris.Prediction model for psoriasis vulgaris recurrence:h(t,X)=h0(t)exp(0.836X1+1.334X2+0.326X3+1.401X4+1.295X5+1.533X6+0.457X7+1.567X9+1.412X10+1.523X11).ROC curve analysis of the model for predicting the recurrence of psoriasis vulgaris:AUC=0.867(95%CI=0.714~0.812,P<0.05),the best prediction truncation value was 0.665,the sensitivity was 73.65%,and the specificity was 93.87.Conclusion Age≥45 years,family history of psoriasis,smoking,drinking,infection,sleep disorders,dampness,irregular medication,trauma,stress,endocrine and metabolic disorders can all lead to the recurrence of psoriasis vulgaris.