预测原发性醛固酮增多症术后血压的转归：Fisher判别模型
发布时间：2019-06-05 08:13
【摘要】：目的探讨原发性醛固酮增多症患者术后血压转归的预测因素并建立Fisher判别模型以在术前预测血压转归。方法收集2010年01月至2015年09月于重庆医科大学附属第一医院手术切除单侧病变或单侧肾上腺的原发性醛固酮增多症83例,根据术后血压是否恢复正常分为治愈组和未愈组。比较两组患者的人口学特征、高血压情况、血尿生化和影像学特征,对有显著差异的变量进行Fisher逐步判别,建立判别模型,并利用受试者工作特征曲线(ROC)与传统的醛固酮瘤缓解评分(Aldosteronoma Resolution Score,ARS)、列线图模型进行比较。结果1)治愈组52例(62.65%),未愈组31例(37.35%)。2)与治愈组相比,未愈组年龄、体重指数(BMI)更大,术前高血压病程更长,使用的降压药物种数更多,血清甘油三酯(TG)、糖尿病患病率、吸烟率和饮酒率更高,而估计肾小球滤过率(eGFR)及HDL-C较治愈组显著为低,CT表现为典型结节的更少(P0.05)。3)以BMI、高血压药物种数、典型CT结节、eGFR、TG建立Fisher判别模型,ROC曲线下面积及95%可信区间(CI)为0.857(0.764-0.951),最佳切点值0.1959时,判别治愈的敏感度和特异性分别为86.5%、83.9%。4)Fisher判别分析模型的曲线下面积高于ARS和列线图模型,两者分别为0.733(0.619-0.847)、0.735(0.619-0.851)。结论Fisher判别模型可以较准确地在术前预测原发性醛固酮增多症术后血压转归,有较好的临床应用价值。
[Abstract]:Objective to investigate the predictors of postoperative blood pressure outcome in patients with primary aldosteronism and to establish Fisher discriminant model to predict blood pressure outcome before operation. Methods 83 cases of primary aldosteronism with unilateral lesion or unilateral adrenal gland resected in the first affiliated Hospital of Chongqing Medical University from January 2010 to September 2015 were divided into cured group and uncured group according to whether the blood pressure returned to normal after operation. The demographic characteristics, hypertension, hematuria biochemical and imaging features of the two groups were compared, and the variables with significant differences were identified by Fisher step by step, and the discriminant model was established. The working characteristic curve (ROC) of the subjects was compared with the traditional aldosterone tumor remission score (Aldosteronoma Resolution Score,ARS) and the line diagram model was compared. Results 1) there were 52 cases (62.65%) in the cured group and 31 cases (37.35%) in the uncured group. 2) compared with the cured group, the age, body mass index (BMI), duration of hypertension and the number of antihypertensive drugs used in the uncured group were longer, and the number of antihypertensive drugs in the uncured group was higher than that in the cured group. The prevalence of serum TG (TG), diabetes mellitus, smoking rate and drinking rate were higher, but the estimated glomerular filtration rate (eGFR) and HDL-C were significantly lower than those in the cured group, and the number of typical nodules on CT was less (P 0.05). 3) BMI, was the most common type of diabetes mellitus. 3) the estimated glomerular filtration rate was significantly lower than that in the cured group (P 0.05). The number of hypertension drugs, typical CT nodules and Fisher discriminant model were established by eGFR,TG. The area under ROC curve and 95% confidence interval (CI) were 0.857 (0.764 鈮，
本文编号：2493377
[Abstract]:Objective to investigate the predictors of postoperative blood pressure outcome in patients with primary aldosteronism and to establish Fisher discriminant model to predict blood pressure outcome before operation. Methods 83 cases of primary aldosteronism with unilateral lesion or unilateral adrenal gland resected in the first affiliated Hospital of Chongqing Medical University from January 2010 to September 2015 were divided into cured group and uncured group according to whether the blood pressure returned to normal after operation. The demographic characteristics, hypertension, hematuria biochemical and imaging features of the two groups were compared, and the variables with significant differences were identified by Fisher step by step, and the discriminant model was established. The working characteristic curve (ROC) of the subjects was compared with the traditional aldosterone tumor remission score (Aldosteronoma Resolution Score,ARS) and the line diagram model was compared. Results 1) there were 52 cases (62.65%) in the cured group and 31 cases (37.35%) in the uncured group. 2) compared with the cured group, the age, body mass index (BMI), duration of hypertension and the number of antihypertensive drugs used in the uncured group were longer, and the number of antihypertensive drugs in the uncured group was higher than that in the cured group. The prevalence of serum TG (TG), diabetes mellitus, smoking rate and drinking rate were higher, but the estimated glomerular filtration rate (eGFR) and HDL-C were significantly lower than those in the cured group, and the number of typical nodules on CT was less (P 0.05). 3) BMI, was the most common type of diabetes mellitus. 3) the estimated glomerular filtration rate was significantly lower than that in the cured group (P 0.05). The number of hypertension drugs, typical CT nodules and Fisher discriminant model were established by eGFR,TG. The area under ROC curve and 95% confidence interval (CI) were 0.857 (0.764 鈮，
本文编号：2493377
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