摘要
目的探究急性脑梗死后偏瘫老年患者发生尿路感染的危险因素,构建列线图预测模型,为临床治疗急性脑梗死后偏瘫老年患者尿路感染提供依据。方法回顾性分析2020年1月至2023年1月在西南医科大学附属医院·合江县人民医院住院治疗的139例急性脑梗死后偏瘫老年患者的病历资料,根据是否合并尿路感染分为感染组(n=60)和非感染组(n=79)。根据既往文献中脑梗患者发生尿路感染的可能因素,筛查急性脑梗死后偏瘫老年患者尿路感染的影响因素,将筛选出的有统计学意义的变量使用Logistic回归模型对影响因素进行分析,得到的危险因素代入R软件中,根据各影响因素的回归系数赋分,构建列线图预测模型,绘制ROC曲线评价预测效能。结果60例发生尿路感染的急性脑梗死后偏瘫老年患者中,革兰阴性菌感染44例(73.33%)、革兰阳性菌感染16例(26.67%)。感染组女性、合并糖尿病、留置导尿管所占比例及血清TLR4、HMGB1、NF-κB水平高于非感染组(P<0.05)。女性(OR=3.691,95%CI:1.812~7.520)、合并糖尿病(OR=3.522,95%CI:1.719~7.238)、留置导尿管(OR=4.023,95%CI:1.910~8.472)、TLR4(OR=4.909,95%CI:2.331~10.338)、HMGB1(OR=4.175,95%CI:1.982~8.792)、NF-κB升高(OR=4.509,95%CI:2.141~9.495)是急性脑梗死后偏瘫老年患者发生尿路感染的危险因素(P<0.05)。列线图模型预测急性脑梗死后偏瘫老年患者发生尿路感染的灵敏度为0.806(95%CI:0.741~0.896),特异度为0.812(95%CI:0.761~0.975),曲线下面积为0.809(95%CI:0.745~0.913)。结论女性、合并糖尿病、留置导尿管及血清TLR4、HMGB1、NF-κB水平升高与急性脑梗死后老年偏瘫患者发生尿路感染有关,构建列线图模型有助于早期预测尿路感染的发生。
Objective To explore the risk factors for urinary tract infection in elderly patients with hemiplegia after acute ischemic stroke,and to construct a nomogram prediction model,so as to provide a basis for clinical treatment of urinary tract infection in elderly patients with acute ischemic stroke.Methods The medical records of 139 elderly patients with hemiplegia after acute ischemic stroke who were hospitalized in the Affiliated Hospital of Southwest Medical University and Hejiang County People’s Hospital from January 2020 to January 2023 were collected and retrospectively analyzed.According to the possible factors of urinary tract infection in patients with cerebral infarction in the previous literature,the influencing factors of urinary tract infection in elderly patients with hemiplegia after acute ischemic stroke were screened,the selected statistically significant variables were analyzed by using the logistic regression model,and the obtained risk factors were substituted into the R software,each influencing factor was assigned according to the size of the regression coefficient,the nomogram prediction model was constructed,and the ROC curve was drawn to evaluate the prediction efficiency.Results Among the 60 elderly patients with acute ischemic stroke-induced hemiplegia who developed urinary tract infections,44 cases(73.33%)were infected with Gramnegative bacteria and 16 cases(26.67%)were infected with Gram-positive bacteria.The infection group had a higher proportion of females,diabetes comorbidity,indwelling urinary catheter use,as well as higher levels of serum TLR4,HMGB1,and NF-κB compared to the non-infection group(P<0.05).Female gender(OR=3.691,95%CI:1.812-7.520),diabetes comorbidity(OR=3.522,95%CI:1.719-7.238),indwelling urinary catheter use(OR=4.023,95%CI:1.910-8.472),TLR4(OR=4.909,95%CI:2.331-10.338),HMGB1(OR=4.175,95%CI:1.982-8.792)and NF-κB(OR=4.509,95%CI:2.141-9.495)evelation were identified as risk factors for urinary tract infections in elderly patients with acute ischemic stroke-induced h
作者
赵应勇
裴金强
ZHAO Yingyong;PEI Jinqiang(Affiliated Hospital of Southwest Medical University·People’s Hospital of Hejiang County,Luzhou,Sichuan 646200,China)
出处
《中国国境卫生检疫杂志》
CAS
2024年第4期399-402,共4页
Chinese Journal of Frontier Health and Quarantine
基金
四川省科技厅应用基础研究基金项目(2020YJ0497)。
关键词
急性脑梗死
偏瘫
尿路感染
预测模型
Acute ischemic stroke
Hemiplegia
Urinary tract infection
Prediction model
