摘要
目的 探讨慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)患者术后预后不良的影响因素,建立logistic回归模型并进行验证,为临床防治工作提供参考。方法 回顾性选取2021年1月至2023年1月郑州市第七人民医院收治的158例CRSwNP患者为研究对象,依据内窥镜术后1 a预后情况分为预后不良组33例、预后良好组125例。比较两组临床资料,分析预后不良的影响因素。依据多因素logistic回归分析结果构建模型,采用Hosmer-Lemeshow检验模型校准度。结果 变应性鼻炎、支气管哮喘、头/面疼痛评分、鼻窦CT评分、术后感染及白细胞介素-17(IL-17)、趋化因子4(CCL4)水平为预后不良的独立危险因素(P<0.05);模型预测术后预后不良的曲线下面积(AUC)为0.906(95%CI:0.812~0.964),预测敏感度、特异度分别为84.85%、86.40%,且具有良好校准度。结论 变应性鼻炎、支气管哮喘、头/面疼痛评分、鼻窦CT评分、术后感染及IL-17、CCL4水平为CRSwNP患者术后预后不良发生的独立危险因素,基于上述影响因素建立logistic回归模型,该模型对预后不良发生具有一定预测价值,临床需重视上述影响因素并实施个体化干预,以降低预后不良发生风险。
Objective To investigate the influencing factors of poor postoperative prognosis in patients with chronic rhinosinusitis with nasal polyp(CRSwNP),establish logistic regression model and verify it,and provide reference for clinical prevention and treatment.Methods A retrospective study was conducted on 158 patients with CRSwNP admitted to the 7th People’s Hospital of Zhengzhou from January 2021 to January 2023.The patients were divided into a poor prognosis group of 33 cases and a good prognosis group of 125 cases based on the prognosis after endoscopic surgery.The clinical data of the two groups were compared,and the influencing factors of poor prognosis were analyzed.A model was constructed based on the results of a multivariate logistic regression analysis,and the Hosmer-Lemeshow test was used to calibrate the model.Results Allergic rhinitis,bronchial asthma,head/face pain score,sinus CT score,postoperative infection,and interleukin-17(IL-17)and chemokine 4(CCL4)levels were independent risk factors for poor prognosis(P<0.05).The area under the curve(AUC)of the model for predicting poor postoperative prognosis was 0.906(95%CI:0.812-0.964),with a sensitivity and specificity of 84.85%and 86.40%,respectively,and good calibration.Conclusion Allergic rhinitis,bronchial asthma,head/face pain score,sinus CT score,postoperative infection,and IL-17 and CCL4 levels are independent risk factors for poor prognosis in CRSwNP patients after surgery.Based on these factors,a logistic regression model was established,which has certain predictive value for the occurrence of poor prognosis.Clinical attention should be paid to these factors and individualized interventions should be implemented to reduce the risk of poor prognosis.
作者
高歌
刘晨晨
杜慧慧
GAO Ge;LIU Chenchen;DU Huihui(Department of Otolaryngology,the 7th People’s Hospital of Zhengzhou,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2024年第20期3704-3707,共4页
Henan Medical Research
