无痛胃肠镜中低血压发生的临床预测模型建立与验证

徐 照清¹, 何 志宣¹, 杨 毅²
1、大理大学临床医学院 云南大理 671000
2、通讯作者大理大学临床医学院 云南大理 671000

摘要

摘要：目的：研究基于临床资料建立并验证无痛胃肠镜中低血压发生的预测模型。方法纳入行无痛胃镜或肠镜的240例患者。根据在无痛胃镜或肠镜检查中是否发生低血压，将患者分为发生组和非发生组；分析比较与无痛胃镜或肠镜中低血压发生的可能相关的15项因素。采用最小绝对收缩和选择算子（LASSO）回归来降低数据维度和筛选预测因子，纳入多因素Logistic回归建立预测模型并制作列线图。受试者工作特征曲线（ROC）和校准曲线用于验证模型的区分度和拟合优度。决策曲线分析评价预测模型的临床适用性。结果LASSO回归筛选出5个预测因子（年龄、ASA分级、高血压病、贫血、镇静药物），纳入Logistic回归并形成列线图。经过验证，模型的ROC曲线下面积为0.97；校准曲线显示预测概率与实际概率有很好的一致性；决策曲线分析则显示模型在一定范围内的临床适用性。结论本研究建立的无痛胃肠镜中低血压发生的预测模型具有良好的区分度、拟合优度和临床适用性，有利于临床上个体化的麻醉方案优化。

关键词

关键词：无痛胃肠镜；低血压；预测模型；危险因素

参考

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