2型糖尿病患者低血糖风险预测模型的构建与验证
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女,硕士在读,护师

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重庆市科学技术局2019年度技术创新与应用发展专项面上项目(cstc2019jscx-msxmX0201)


Establishment and verification of a hypoglycemia risk prediction model for type 2 diabetic patients
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    目的 构建2型糖尿病患者低血糖风险预测模型,并验证其临床预测效果。 方法 采用便利抽样法选取1 149例2型糖尿病患者相关资料,随机分为建模组(766例)、验证组(383例),采用Logistic回归分析构建预测模型、Hosmer-Lemeshow(H-L)检验模型的拟合优度及受试者工作特征曲线下面积判断模型的预测效果。 结果 建模组、验证组低血糖发生率分别为26.76%、23.24%;Logistic回归分析结果显示:体重指数(OR=0.120)、住院时间(OR=2.052)、糖尿病病程(OR=6.434)、周围血管病变(OR=2.979)、糖化血红蛋白(OR=0.215)和三酰甘油(OR=0.470)是低血糖发生的主要影响因素;构建模型的受试者工作特征曲线下面积为0.867,约登指数最大值为0.614,最佳临界值为0.329,对应的灵敏度为0.766、特异度为0.848,H-L检验P=0.071;验证组独立数据检验结果显示,受试者工作特征曲线下面积为0.895,灵敏度为0.730,特异度为0.884。 结论 构建的预测模型效能较好,可为临床医护人员早期识别2型糖尿病低血糖高危人群提供参考。

    Abstract:

    Objective To establish a hypoglycemia risk prediction model for type 2 diabetic patients, and to verify its predictive effect. Methods The related data of 1149 type 2 diabetic patients were selected using convenience sampling, which were then randomized into a modeling group (n=766) and a validation group (n=383).The logistic regression analysis was used to establish the prediction model, the Hosmer-Lemeshow test and the area under the ROC curve were utilized to judge the goodness of fit and predictive effect of the model. Results The occurrence rate of hypoglycemia in the modeling group and validation group was 26.76% and 23.24% respectively. The logistic regression analysis showed that, body mass index (OR=0.120), length of hospital stay (OR=2.052), duration of diabetes (OR=6.434), peripheral vascular disease (OR=2.979), glycosylated hemoglobin (OR=0.215) and triacylglycerol (OR=0.470) were the main influencing factors of hypoglycemia. As for the modeling group, the area under the ROC curve was 0.867, with the maximum value of Youden index was 0.614, the optimal critical value was 0.329, the sensitivity was 0.766, the specificity was 0.848, and H-L test P=0.071.The test results of the validation group data indicated that, the area under the ROC curve was 0.895, the sensitivity was 0.730, and specificity was 0.884. Conclusion The established prediction model has good predictive effect, which could provide reference for clinical medical staff identifying the high-risk groups of hypoglycemia early.

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左丹,赵锡丽,代旭丽.2型糖尿病患者低血糖风险预测模型的构建与验证[J].护理学杂志,2021,36(1):30-33

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  • 收稿日期:2020-08-31
  • 最后修改日期:2020-10-08
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  • 在线发布日期: 2022-09-17