摘要
目的探讨男性勃起功能障碍(ED)发生的影响因素,构建ED发生的列线图风险模型,并评价模型的预测效能。方法选取2019年2月至2021年6月在廊坊市第四人民医院行健康体检的199例成年男性作为研究对象。采用国际勃起功能指数-5(IIEF-5)进行评定,根据有无ED分成ED组(n=56)和非ED组(n=143)。获取两组人口学特征、手术史、日常行为情况、合并疾病、心理状况、血清性激素水平等资料开展单因素分析,通过Logistic回归分析确定成年男性ED发生的影响因素,利用R软件中的RMS包绘制预测成年男性ED发生的列线图风险模型,并通过受试者工作特征(ROC)曲线下面积(AUC)和H-L拟合优度验证其区分度和精确度。结果199例成年男性中,56例发生ED,发生率为28.14%。两组年龄、糖尿病比例、血脂异常比例、前列腺增生比例、焦虑比例、血清睾酮水平比较,差异具有统计学意义(P<0.05);Logistic回归分析结果显示,成年男性ED发生的影响因素主要有年龄、糖尿病、前列腺增生、焦虑、血清睾酮水平(P<0.05);ROC和校准曲线分析结果显示,构建的风险模型区分度(AUC为0.792,95%CI为0.729~0.855)和精准度(H-L拟合优度检验χ^(2)=12.500,P=0.130)均较高。结论基于年龄、糖尿病、前列腺增生、焦虑、血清睾酮水平等5项因素构建的列线图风险模式对成年男性发生ED的预测效果较好。
Objective To explore the infuencing factors of male erectile dysfunction(ED),construct a nomogram risk model for ED,and evaluate the predictive efficiency of this model.Methods Adult males who came to Langfang Fourth People's Hospital for health checkup from February 2019 to June 2021 were selected as the research subjects.Their erectile function were assessed by the international index of erectile function-5(IIEF-5),and were divided into ED group(n=56)and non-ED group(n=143)according to the presence of ED.The data of the two groups were obtained for demographic characteristics,surgical history,daily behavior,co-morbidities,psychological status and serum sex hormone levels,and Logistic regression analysis was used to determine the factors influencing the occurrence of ED.The regression model strategies(RMS)package in the R software was used to develop a nomogram risk model for predicting the occurrence of ED in adult males,and its differentiation and accunacy were venified by area under curve(AUC)of receiver operating characteristic curve(ROC)and H-L goodness of fit test.Results This study included 199 adult males,of which 56 had ED,with incidence rate of 28.14%.There were signifcant diferences in age,diabetes ratio,dysipidemia ratio,prostate hyperplasia ratio,anxiety ratio,serum testosterone level between ED group and non-ED group(P<0.05);Logistic regression analysis showed that the main influencing factors of ED in adult males were age,diabetes,prostatic hyperplasia,anxiety and serum testosterone level(P<0.05);ROC and calibration curve analysis results showed that the constructed risk model had higher discrimination(AUC:0.792,95%Cl;0.729-0.855)and precision(H-L goodness of fit testχ^(2)=12.500,P=0.130).Conclusions The nomogram risk model constructed based on five factors including age,diabetes,prostatic hyperplasia,anxiety and serum testosterone level has a well prediction effect on the occurrence of ED in adult males.
作者
杨绍威
康春卯
赵辉
李军
刘俊鹤
YANG Shaowei;KANG Chunmao;ZHAO Hui;LI Jun;LIU Junhe(Department of Urology,Langfang Fourth People's Hospital,Lanfang 065700,Hebei,China;Rehabilitation Department of Traditional Chinese Medicine,Langfang Fouth People's Hospital,Langfang 065700,Hebei,China)
出处
《中国性科学》
2023年第6期44-48,共5页
Chinese Journal of Human Sexuality
基金
河北省中医药管理局科研课题(2022579)。
