이전|다음

증상과 증후 결합 모델 하에서 만성 폐쇄성 폐질환 빈번한 급성 악화 위험 예측 모델 구축

  • role： First author第一作者
  • Affiliation：

    The First Clinical Medical College of Anhui University of Traditional Chinese Medicine， The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China

  • Email：1558809476@qq.com
  • Introduction：周静，博士，主治医师，从事中医药防治呼吸系统疾病研究，E-mail：1558809476@qq.com
ZHOU Jing,  
  • Affiliation：

    The First Clinical Medical College of Anhui University of Traditional Chinese Medicine， The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China

TENG Gang,  
  • role： Corresponding author通信作者
  • Affiliation：

    The First Clinical Medical College of Anhui University of Traditional Chinese Medicine， The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China

  • Email：zhangnz@ahtcm.edu.cn
  • Introduction：张念志，博士，主任医师，从事中医药防治呼吸系统疾病研究，E-mail：zhangnz@ahtcm.edu.cn
ZHANG Nianzhi*,  
  • Affiliation：

    The First Clinical Medical College of Anhui University of Traditional Chinese Medicine， The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China

WANG Yuanyuan,  
  • Affiliation：

    The First Clinical Medical College of Anhui University of Traditional Chinese Medicine， The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China

ZHANG Qianqian,  
  • Affiliation：

    The First Clinical Medical College of Anhui University of Traditional Chinese Medicine， The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China

HUANG He,  
  • Affiliation：

    The First Clinical Medical College of Anhui University of Traditional Chinese Medicine， The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China

LIU Ling,  
  • Affiliation：

    The First Clinical Medical College of Anhui University of Traditional Chinese Medicine， The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China

DONG Mei,  
  • Affiliation：

    The First Clinical Medical College of Anhui University of Traditional Chinese Medicine， The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China

JI Juan

추상적인

목적은 증상과 증후 결합 모델 하에서 만성 폐쇄성 폐질환(COPD)의 빈번한 급성 악화 위험 예측 모델을 구축하여 임상에서 정밀 개입을 위한 의사결정 지원을 제공하는 것이다. 방법: 2020년 1월부터 2024년 8월까지 안후이 중의약대학교 제1부속병원에 입원한 COPD 급성 악화 환자 2,029명을 후향적으로 포함하였으며, 연간 입원 횟수에 따라 빈번 급성 악화군(≥2회/년)과 비빈번 급성 악화군(<2회/년)으로 구분하였다. LASSO 회귀와 로지스틱 회귀를 결합하여 위험 인자를 선별하고, 열선도 모델을 구축하였으며, 곡선 아래 면적(AUC), 보정 곡선 및 임상 의사결정 곡선(DCA)을 이용해 모델 성능을 평가하였다. 결과: 빈번 급성 악화군(1,196명)과 비빈번 급성 악화군(833명)의 기저 특성 차이는 통계적으로 유의하지 않았다. LASSO 회귀와 다중 로지스틱 회귀를 통해 체질량 지수(BMI), 입원 일수, 흡연 기간, 거주지, 비침습적 환기기 사용, 산소요법 필요, 간경변, 전신성 당질코르티코이드 사용, 중의 증형(담어폐체) 등의 독립 위험 인자를 선별하였다. 열선도 모델은 훈련 세트(AUC=0.748)와 검증 세트(AUC=0.774) 모두에서 우수한 변별력과 보정도를 보였다. 결론: 본 연구에서 구축한 중의 증후 융합 COPD 빈번 급성 악화 위험 예측 모델은 정확도가 높아 고위험 환자의 조기 선별과 맞춤형 개입을 위한 과학적 근거를 제공할 수 있다.

키워드

만성 폐쇄성 폐질환 급성 악화기; 빈번 급성 악화; 열선도; 임상 예측 모델; 증상과 증후 결합

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