摘要
目的探讨突发性耳聋并发良性阵发性位置性眩晕(BPPV)的风险因素,据此构建列线图预测模型。方法回顾性分析2020年2月至2022年3月新乡医学院第一附属医院收治的406例突发性耳聋患者临床资料,随机抽取70%为建模组(284例),30%为验证组(122例)。根据患者是否并发BPPV,将建模组进一步分为并发组(52例)和未并发组(232例),比较两组患者一般资料,选择差异有统计学意义的指标用向前逐步回归法进行非条件多因素logistic回归分析突发性耳聋合并BPPV的影响因素,并采用R3.4.3软件包绘制基于多因素分析结果的列线图模型。另分别对建模组和验证组绘制受试者工作特征(ROC)曲线以评估列线图模型的预测效能,同时绘制校准曲线并采用Bootstrap法检验预测列线图的校准度。结果并发组老年、高血压、糖尿病、骨质疏松症、听力重度或极重度损伤、全聋型听力曲线占比高于未并发组(P<0.05);经多因素logistic回归分析显示,老年、高血压、糖尿病、骨质疏松症、听力重度或极重度损伤、全聋型听力曲线均是突发性耳聋并发BPPV的危险因素(P<0.05);经Bootstrap法进行验证,一致性指数(C-index)为0.837,校正曲线与标准曲线贴合度较好。结论老年、高血压、糖尿病、骨质疏松症、听力重度或极重度损伤、全聋型听力曲线均是突发性耳聋并发BPPV的危险因素,综合上述因素构建的列线图预测模型可以较好地个体化预测突发性耳聋BPPV的发生,为临床筛查并发BPPV的高危人群提供借鉴。
Objective To explore the risk factors of sudden deafness complicated with benign paroxysmal positional vertigo(BPPV),and to construct a nomogram prediction model based on this.Methods The clinical data of 406 patients with sudden deafness admitted to the First Affiliated Hospital of Xinxiang Medical College from February 2020 to March 2022 were retrospectively analyzed,and 70%were randomly selected as the modeling group(284 cases)and 30%as the validation group(122 cases).According to whether the patients were complicated with BPPV,the modeling group were further divided into concurrent group(52 cases)and non-concurrent group(232 cases).The general data of the two groups were compared,and the statistically significant indicators were selected for unconditional multivariate logistic regression analysis by forward stepwise regression method.R3.4.3 software package was used to draw the nomogram model based on the results of multi factor analysis.The receiver operating characteristic(ROC)curve was drawn for the modeling group and the validation group respectively to evaluate the predictive effectiveness of the nomogram model.The calibration curve was drawn to test the calibration of the predictive nomogram by Bootstrap method.Results The proportions of elderly,hypertension,diabetes,osteoporosis,severe or extremely severe hearing impairment and total deafness hearing curve in the concurrent group were higher than those in the non concurrent group(P<0.05).Multivariate logistic regression analysis showed that elderly,hypertension,diabetes,osteoporosis,severe or extremely severe hearing impairment and total deafness hearing curve were all risk factors of sudden deafness complicated with BPPV(P<0.05).The internal verification by Bootstrap method showed that the consistency index(C-index)was 0.837,and the correction curve was in good agreement with the standard curve.Conclusion Elderly,hypertension,diabetes,osteoporosis,severe or extremely severe hearing impairment and total deafness hearing curve are all risk factors of su
作者
李晓
鲁保才
LI Xiao;LU Baocai(Department of Otolaryngology,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China)
出处
《河南医学研究》
CAS
2023年第21期3902-3906,共5页
Henan Medical Research
