帕金森病患者发生直立性低血压的风险预测模型构建

Construction of risk prediction model for orthostatic hypotension in patients with Parkinson's disease

目的探讨帕金森病患者发生直立性低血压的影响因素,并构建风险预测模型。方法选取某医院2020年4月至2021年8月收治的288例帕金森病患者为研究对象,根据是否发生直立性低血压分为直立性低血压组和非直立性低血压组。采用Logistic回归分析帕金森病患者发生直立性低血压的影响因素,基于此构建风险预测列线图模型,并进行内部验证。采用Hosmer-Lemeshow拟合优度检验分析列线图模型一致性,受试者工作特征曲线评估列线图模型的预测价值。结果288例帕金森病患者中92例发生直立性低血压,发生率为31.94%。年龄、体质指数、高血压史、糖尿病史、Hoehn-Yahr分级、快速眼动期睡眠行为障碍、长期卧床休息、便秘、总左旋多巴等效剂量是帕金森病患者发生直立性低血压的影响因素(P<0.05)。Hosmer-Lemeshow拟合优度检验结果显示,列线图模型一致性良好(χ^(2)=1.248,P=0.428)。ROC曲线下面积为0.995(95%CI:0.990,0.999),灵敏度为0.989,特异度为0.934。结论帕金森病患者直立性低血压发生率较高。基于影响因素构建的帕金森病患者发生直立性低血压风险预测列线图模型可为临床诊疗提供一定的参考依据。

Objective To explore the influencing factors of orthostatic hypotension in patients with Parkinson's disease,and to construct a risk prediction model.Methods A total of 288 patients with Parkinson's disease admitted to a hospital from April 2020 to August 2021 were selected as the research objects.According to whether orthostatic hypotension occurred,they were divided into orthostatic hypotension group and non-orthostatic hypotension group.Logistic regression analysis was used to analyze the risk factors of orthostatic hypotension in patients with Parkinson's disease.Based on this,a nomogram risk prediction model was constructed and internal verification was performed.The Hosmer-Lemeshow goodness of fit test was used to analyze the consistency of the nomogram model,and the receiver operating characteristic curve was used to evaluate the predictive value of the nomogram model.Results There were 92 cases of orthostatic hypotension in 288 patients with Parkinson's disease,and the incidence was 31.94%.Age,body mass index,history of hypertension,history of diabetes,Hoehn-Yahr stage,rapid eye movement sleep behavior disorder,long-term bed rest,constipation,and total levodopa equivalent daily dose were independent risk factors for Parkinson's disease patients with orthostatic hypotension(P<0.05).The result of the Hosmer-Lemeshow goodness of fit test showed that the consistency of the nomogram model was in good agreement(χ^(2)=1.248,P=0.428).The area under the curve of ROC was 0.995(95%CI:0.990,0.999),with a sensitivity of 0.989 and a specificity of 0.934.Conclusion The incidence of orthostatic hypotension in Parkinson's disease is relatively high,a nomogram risk prediction model for Parkinson's disease patients with orthostatic hypotension based on independent risk factors can provide a certain reference for clinical diagnosis and treatment.