恶性肿瘤患者衰弱综合征风险评估模型的构建与评价

doi:10.20047/j.issn1673-7210.2023.24.14

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摘要目的探讨恶性肿瘤患者衰弱综合征的相关因素，并构建风险评估模型，预测其效能。方法选取2020年5月至8月在广西某三甲医院肿瘤科住院的恶性肿瘤患者327例，收集患者一般资料、实验室指标，测量握力大小，采用二元logistic回归分析确定风险评估模型，使用受试者工作特征曲线检验模型效果。结果恶性肿瘤患者衰弱综合征的发生率为28.4%。两组性别、年龄、握力、臂围、小腿围、体重指数、红细胞、血红蛋白、总蛋白、白蛋白及前白蛋白比较，差异有统计学意义（P＜0.05）。logistic回归结果显示，性别、握力、臂围、白蛋白是恶性肿瘤患者衰弱综合征的影响因素（OR＜1，P＜0.05）。采用H-L拟合优度检验对构建的衰弱综合征风险预测模型进行检验（χ2=9.689，P=0.288），模型拟合较好。ROC曲线下面积为0.852（95%CI：0.807～0.897，P＜0.05），灵敏度为0.849，特异度为0.722时，Youden指数最大（0.572），预测模型分数为149分。结论恶性肿瘤患者衰弱综合征发生率较高，女性患者及较低的臂围、握力、白蛋白是恶性肿瘤患者衰弱综合征的危险因素，149分是恶性肿瘤患者衰弱综合征风险评估模型的最佳临界值，构建的衰弱综合征风险评估模型具有较好的诊断效能，可进行下一步的大样本临床验证。

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	韦洁静1*　　卢婷2*　　应燕萍3　　黄彪进3　　徐谊4

关键词 ：恶性肿瘤, 衰弱综合征, 模型

Abstract：Objective To investigate the related factors of asthenic syndrome in patients with malignant tumors, and construct a risk assessment model to predict its efficacy. Methods A total of 327 patients with malignant tumors who were hospitalized in the oncology department of a top-three hospital in Guangxi from May to August 2020 were selected. General data and laboratory indicators of the patients were collected, and grip strength was measured. The risk assessment model was determined by binary logistic regression analysis, and the model effect was tested by subject working characteristic curve. Results The incidence of asthenic syndrome in malignant tumor patients was 28.4%. There were significant differences in gender, age, grip strength, arm circumference, calf circumference, body mass index, erythrocyte, hemoglobin, total protein, albumin and prealbumin between the two groups (P＜0.05). Logistic regression results showed that gender, grip strength, arm circumference and albumin were the influencing factors of asthenic syndrome in malignant tumor patients (OR＜1, P＜0.05). H-L goodness of fit test was used to test the FMS risk prediction model (P＞0.05), and the model fit was good. When the area under ROC curve was 0.852 (95%CI: 0.807-0.897, P＜0.05), the sensitivity was 0.849, and the specificity was 0.722, the Youden index was the largest (0.572), and the prediction model score was 149 points. Conclusion The incidence of asthenic syndrome is high in patients with malignant tumors, and female patients and lower arm circumference, grip strength and albumin are risk factors for asthenic syndrome in patients with malignant tumors. 149 points is the optimal threshold value for the asthenic syndrome risk assessment model in patients with malignant tumors. The constructed asthenic syndrome risk assessment model has good diagnostic efficacy and can be verified in the next large sample.

Key words： Malignant tumor Asthenic syndrome Model

基金资助:国家自然科学基金资助项目（81860032）；
广西自然科学基金资助项目（2018GXNSFAA050081）。

通讯作者: 徐谊（1991-），男，硕士；研究方向：胸部肿瘤。

作者简介: 卢婷（1995-），女，硕士；研究方向：肿瘤护理。 *具有同等贡献

引用本文:

韦洁静1*　　卢婷2*　　应燕萍3　　黄彪进3　　徐谊4. 恶性肿瘤患者衰弱综合征风险评估模型的构建与评价[J]. 中国医药导报, 2023, 20(24): 59-63.
WEI Jiejing1*　LU Ting2*　YING Yanping3　HUANG Biaojin3　XU Yi4. Construction and evaluation of a risk assessment model for asthenic syndrome in patients with malignant tumors. 中国医药导报, 2023, 20(24): 59-63.

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