摘要
目的建立山东省≥40岁人群慢性阻塞性肺疾病(COPD)患病风险的列线图预测模型,为提高COPD的早诊早治率及降低COPD的疾病负担提供参考依据。方法收集2019年中国居民COPD监测中山东省4558名≥40岁人群监测数据,应用多因素非条件logistic回归分析方法筛选相关因素建立COPD患病风险列线图预测模型,并采用受试者工作特征(ROC)曲线和校准曲线对预测模型进行拟合效应检验。结果多因素非条件logistic回归分析结果显示,年龄≥50岁、患慢性支气管炎、患肺结核、父母患慢性支气管炎、感冒时出现喘鸣音、有1次或反复发作的喘息、以前吸烟、现在吸烟、14岁及以前经常接触二手烟和14岁及以前患过肺炎或支气管炎是山东省≥40人群COPD患病的危险因素,女性、肥胖和做饭时通风是山东省≥40人群COPD患病的保护因素;以此12个变量建立山东省≥40岁人群COPD患病风险列线图预测模型,模型的ROC曲线下面积为0.786(95%CI=0.766~0.806),C-index指数为0.786,模型拟合χ^(2)值为0.40,P值为0.818,预测值与实际值基本一致,此模型具有较好的预测效果。结论本研究构建的山东省≥40岁人群COPD患病风险列线图预测模型具有较好的预测效果,可在社区人群的COPD初筛中进行推广。
Objective To establish a nomogram-based risk prediction model for chronic obstructive pulmonary disease(COPD)among individuals aged 40 years and over for improving early diagnosis and treatment of COPD in the population.Methods The data on COPD surveillance in 2019 among 4558 residents at ages of 40 years and above in Shandong province were collected.Significant impact factors of COPD were screened out with unconditional logistic regression analysis to establish a nomogram model for predicting COPD risk.Receiver operating characteristic(ROC)curve and calibration curve were used to test the fitting of the established model.Results Logistic regression analysis revealed following significant impact factors of COPD:9 risk factors consisting of at ages of 50 and above,disease history of chronic bronchitis,disease history of tuberculosis,parental disease history of chronic bronchitis,with wheezing while suffering from cold,history of recurrent wheezing,ever smoking,current smoking,frequent exposure to secondhand smoke before the age of 14,disease history of pneumonia or bronchitis before the age of 14 and 3 protective factors including female gender,being obesity,and having ventilation while cooking.Using the 12 influencing factors identified,a well-fitting nomogram model for COPD risk prediction was established,with the area under the ROC curve(AUC)of 0.786(95%confidence interval:0.766–0.806)and the concordance index(C-index)of 0.786.There was no significant difference between the model-predicted data and actual data(χ^(2)=0.40,P=0.818).Conclusion The established nomogram model is of good effect for predicting COPD risk in community residents aged 40 years and above and could be adopted in primary screening of the disease in the population.
作者
董秋月
高丛丛
刘才睿
张丙银
郭晓雷
贾存显
鹿子龙
DONG Qiuyue;GAO Congcong;LIU Cairui(School of Public Health,Cheeloo College of Medicine,Shandong University,Ji'nan,Shandong Province 250012,China;不详)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2023年第5期604-611,共8页
Chinese Journal of Public Health
基金
山东省医药卫生科技发展计划项目(202012051237)。
关键词
慢性阻塞性肺疾病(COPD)
患病风险
列线图预测模型
建立
≥40岁人群
chronic obstructive pulmonary disease
disease risk
nomogram-based prediction model
establishment
population aged 40 years and over
