| 基于多维度临床指标构建列线图模型预测膝骨关节炎预后 |
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投稿时间：2022-08-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 王新 |
WANG Xin |
广西梧州市中医医院骨二科, 广西 梧州 543000 |
Department of Orthopaedics, Guangxi Wuzhou Traditional Chinese Medicine Hospital, Wuzhou 543000, Guangxi, China |
zgwscye@yeah.net |
| 叶从军 |
YE Cong-jun |
广西梧州市中医医院骨二科, 广西 梧州 543000 |
Department of Orthopaedics, Guangxi Wuzhou Traditional Chinese Medicine Hospital, Wuzhou 543000, Guangxi, China |
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| 邓振中 |
DENG Zhen-zhong |
广西梧州市中医医院骨二科, 广西 梧州 543000 |
Department of Orthopaedics, Guangxi Wuzhou Traditional Chinese Medicine Hospital, Wuzhou 543000, Guangxi, China |
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| 薛琰 |
XUE Yan |
广西梧州市中医医院骨二科, 广西 梧州 543000 |
Department of Orthopaedics, Guangxi Wuzhou Traditional Chinese Medicine Hospital, Wuzhou 543000, Guangxi, China |
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| 韦晨晖 |
WEI Chen-hui |
广西梧州市中医医院骨二科, 广西 梧州 543000 |
Department of Orthopaedics, Guangxi Wuzhou Traditional Chinese Medicine Hospital, Wuzhou 543000, Guangxi, China |
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| 黎庆标 |
LI Qing-biao |
广西梧州市中医医院骨二科, 广西 梧州 543000 |
Department of Orthopaedics, Guangxi Wuzhou Traditional Chinese Medicine Hospital, Wuzhou 543000, Guangxi, China |
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| 罗扬明 |
LUO Yang-ming |
广西梧州市中医医院骨二科, 广西 梧州 543000 |
Department of Orthopaedics, Guangxi Wuzhou Traditional Chinese Medicine Hospital, Wuzhou 543000, Guangxi, China |
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| 甘键钟 |
GAN Jian-zhong |
广西梧州市中医医院骨二科, 广西 梧州 543000 |
Department of Orthopaedics, Guangxi Wuzhou Traditional Chinese Medicine Hospital, Wuzhou 543000, Guangxi, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第2期，第184-190页 |
| DOI：10.12200/j.issn.1003-0034.20220337 |
| 基金项目: |
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中文摘要:
目的：分析膝骨关节炎（knee osteoarthritis，KOA）患者预后的影响因素并联合多维度临床指标构建列线图预测模型。
方法：回顾性分析2015年1月至2021年6月接受治疗的234例KOA患者的临床资料，男126例，女108例；年龄>60岁135例，年龄≤ 60岁99例。采用Lysholm膝关节功能评分评估患者的预后，并根据患者预后情况分为预后良好组155例与预后不良组79例。将研究对象的临床资料进行单因素与多因素分析，研究对象分为试验队列与验证队列，将多因素分析结果进行可视化处理获得列线图预测模型。采用受试者工作特征（receiver operating characteristic，ROC）曲线，校准曲线以及决策曲线评价模型的区分度，准确性和临床获益率。
结果：多因素分析结果显示吸烟、治疗前K-L分级Ⅲ-Ⅳ级、白细胞介素-6（interleukin 6，IL-6）与基质金属蛋白酶-3（matrix metallo proteinase-3，MMP-3）水平高是KOA患者预后的危险因素。ROC检验结果显示列线图模型在试验队列与验证队列的曲线下面积分别为0.806[95% CI （0.742，0.866）]与0.786[95% CI （0.678，0.893）]；校准曲线结果显示实验队列与验证队列的Brier值分别为0.151分与0.134分；当决策曲线中阈概率的值设定为31%时，实验队列与验证队列的临床获益率分别为51%与56%。
结论：基于多维度临床资料构建的KOA患者预后模型具有理论与实际双重意义，可为采取针对性措施提高患者预后提供参考。 |
| 【关键词】膝骨关节炎 预后 多因素分析 列线图模型 |
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| Clinical study of constructing nomogram model based on multi-dimensional clinical indicators to predict prognosis of knee osteoarthritis |
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ABSTRACT
Objective To analyze the factors affecting the prognosis of patients with knee osteoarthritis, and to construct a nomogram prediction model in conjunction with multi-dimensional clinical indicators.
Methods The clinical data of 234 patients with knee osteoarthritis who were treated in our hospital from January 2015 to June 2021 were retrospectively analyzed, including 126 males and 108 females;age more than 60 years old for 135 cases, age less than 60 years old for 99 cases. Lysholm knee function score was used to evaluate the prognosis of the patients, and the patients were divided into good prognosis group for 155 patients and poor prognosis group for 79 patients according to the prognosis. The clinical data of the subjects in the experimental cohort were analyzed by single factor and multiple factors. The patients were divided into experimental cohort and verification cohort, the results of the multiple factor analysis were visualized to obtain a nomogram prediction model, the receiver operating characteristic curve(ROC), calibration curve and decision curve were used to evaluate the model's discrimination, accuracy and clinical benefit rate.
Results The results of multivariate analysis showed that smoking, pre-treatment K-L grades of Ⅲ to Ⅳ, and high levels of interleukin 6 (IL-6) and matrix metallo proteinase-3 (MMP-3) were risk factors for the prognosis of patients with knee osteoarthritis. ROC test results showed that the area under the curve of the nomogram model in the experimental cohort and validation cohort was 0.806[95%CI(0.742, 0.866)] and 0.786[(95%CI(0.678, 0.893)], respectively. The results of the calibration curve showed that the Brier values of the experimental cohort and verification cohort were 0.151 points and 0.134 points, respectively. When the threshold probability value in the decision curve was set to 31%, the clinical benefit rates of the experimental cohort and validation cohort were 51% and 56%, respectively.
Conclusion The prognostic model of patients with knee osteoarthritis constructed based on multi-dimensional clinical data has both theoretical and practical significance, and can provide a reference for taking targeted measures to improve the prognosis of patients. |
| KEY WORDS Knee osteoarthritis Prognosis Multivariate analysis Nomogram model |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王新,叶从军,邓振中,薛琰,韦晨晖,黎庆标,罗扬明,甘键钟.基于多维度临床指标构建列线图模型预测膝骨关节炎预后[J].中国骨伤,2024,37(2):184~190 |
| 英文格式: | WANG Xin,YE Cong-jun,DENG Zhen-zhong,XUE Yan,WEI Chen-hui,LI Qing-biao,LUO Yang-ming,GAN Jian-zhong.Clinical study of constructing nomogram model based on multi-dimensional clinical indicators to predict prognosis of knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(2):184~190 |
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