文章摘要
下肢动脉硬化闭塞症患者恐动症发生风险的诺模图模型的建立
Establishment of a nomogram model for risk of kineshobia in patients with lower extremity arteriosclerotic occlusive disease
投稿时间:2025-02-20  
DOI:10.3969/j.issn.1000-0399.2026.04.011
中文关键词: 下肢动脉硬化闭塞症  恐动症  影响因素  诺模图模型
英文关键词: Lower extremity arteriosclerosis obliterans  Kinetophobia  Influencing factors  Nomogram model
基金项目:中国博士后科学基金第73批面上资助(编号:2023M731408)
作者单位E-mail
周雪芹 210029 江苏南京 南京医科大学第一附属医院普外血管外科  
桂亮 210029 江苏南京 南京医科大学第一附属医院普外血管外科  
柏小丹 210029 江苏南京 南京医科大学第一附属医院普外血管外科 BaiXiaodan1233@163.com 
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中文摘要:
      目的 分析下肢动脉硬化闭塞症(ASO)患者恐动症发生的危险因素,并构建下肢动脉ASO患者恐动症发生风险的列线图预测模型。方法 采用便利抽样法选择2020年2月至2024年1月南京医科大学第一附属医院收治的228例ASO患者为对象,统一收集临床资料,根据患者是否发生恐动症将其分为恐动症组(86例)和非恐动症组(142例)。采用logistic回归分析筛选ASO患者恐动症发生的危险因素,通过R(R 4.2.1)语言软件构建预测ASO患者恐动症发生的列线图预测模型,应用Hosmer-Lemeshow检验评价模型拟合度,最后采用受试者工作特征(ROC)曲线的曲线下面积(AUC)、校准曲线、决策曲线分析评估模型的区分度、校准度及临床价值。结果 228例ASO患者的恐动症发生率为37.72%;logistic回归分析显示,年龄≥60岁、小学及以下受教育程度、Fontaine分期Ⅳ期、下肢功能较差、有焦虑抑郁、重度疼痛、运动益处认知较差、家庭关怀度较差是恐动症发生的危险因素(P<0.05)。经H-L检验得到χ2=10.706,P=0219。ROC分析显示,本研究构建的ASO患者恐动症发生列线图模型的AUC为0.834,灵敏度和特异度分别为78.60%和83.10%,当校准曲线为23%~85%时,校准曲线预测值和实际值较为接近;当模型的预测阈值概率>12%时,使用本研究构建的列线图预测ASO患者恐动症发生风险的净获益值最高。结论 本研究基于年龄、受教育程度、Fontaine分期、下肢功能、焦虑抑郁、疼痛程度、运动益处认知、家庭关怀度构建的ASO患者恐动症列线图模型对临床识别高风险人群具有一定价值,可用于ASO患者恐动症的风险评估。
英文摘要:
      Objective To analyze the risk factors of kinetophobia in patients with lower extremity arteriosclerotic obliterans (ASO), and to construct a prediction model of kinetophobia in patients with ASO. Methods By using the convenience sampling method, 228 cases of ASO admitted to the First Affiliated Hospital of Nanjing Medical University from February 2020 to January 2024 were selected as the subjects. The clinical data were collected uniformly, and the patients were divided into the kinesiophobia group (86 cases) and the non-kinesiophobia group (142 cases) according to whether they developed kinesiophobia. Logistic regression analysis was used to screen the risk factors for the occurrence of kinesophobia in ASO patients. A nomogram prediction model for predicting the occurrence of kinesophobia in ASO patients was constructed through R (R4.2.1) language software. The Hosmer-Lemeshow test was applied to evaluate the model fit. Finally, the area under the receiver operating characteristic (ROC) curve (AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the discrimination, calibration, and clinical influence of the model. Results The incidence of kineshobia among 228 ASO patients was 37.72%. Logistic regression analysis showed that age ≥60 years old, primary school education or below, Fontaine stage Ⅳ, poor lower extremity function, anxiety and depression, severe pain, poor cognition of the benefits of exercise, and poor family care were risk factors for the occurrence of kinesophobia (P<0.05). The H-L test yielded χ2=10.706 and P=0219. ROC analysis showed that the AUC value of the nomogram model for the occurrence of kineshobia in ASO patients constructed in this study was 0.834, and the sensitivity and specificity was 78.60% and 83.10%, respectively. When the correction curve was 23%~85%, the predicted value of the correction curve was relatively close to the actual value. When the prediction threshold probability of the model was greater than 12%, the net benefit value of predicting the risk of kinesophobia in ASO patients using the nomogram constructed in this study was the highest Conclusion The ASO patient kineshobia risk prediction model constructed based on age, education level, Fontaine stage, lower limb function, anxiety and depression, pain severity, perception of exercise benefits, and family care degree has certain predictive value for clinical identification of high-risk individuals, and can be used for risk assessment of kineshobia in ASO patients.
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