广西医科大学学报2023，Vol.40Issue(12)：2064-2070,7.DOI:10.16190/j.cnki.45-1211/r.2023.12.020
基于超声指标预测产后压力性尿失禁列线图模型建立与验证
Establishment and validation of a Nomogram model for predicting postpartum stress urinary incontinence based on ultrasound indicators
摘要
Abstract
Objective:To establish a Nomogram model for predicting postpartum stress urinary incontinence(SUI)based on ultrasound indicators and validate it.Methods:A total of 413 women who gave birth in Dazhou Integrated TCM&Western Medicine Hospital and underwent pelvic floor ultrasonography 3 months after deliv-ery from January 2021 to January 2023 were selected for the study and divided into model group with 289 cases and validation group with 124 cases in a 7:3 ratio.The general data of the patients were collected,and two-dimen-sional and three-dimensional pelvic floor ultrasound examination and real-time shear wave elastography of the pu-borectalis muscles were performed.According to the presence or absence of postpartum SUI,the model group of parturients was divided into two groups.The general data and ultrasound indicators of the two groups were com-pared,and potential factors were screened using LASSO regression.Independent influencing factors were evalu-ated using logistic regression,and the Nomogram model was established using R language for validation.Re-sults:In the model group of 289 patients,there were a total of 48 cases(16.61%).There were significant differ-ences in pre-pregnancy BMI,parity,delivery mode,perineal laceration,constipation,newborn birth weight,Ry,Vy,Rα,Vα,Vβ,BND,URA,bladder neck funnel,LHA1,LHA2,E1,E2 and△E between the SUI group and the non-SUI group(P＜0.05).The results of multiple lo-gistic regression analysis based on LASSO regression showed that pre-pregnancy BMI,Ry,Vy,BND,URA,bladder neck funnel,LHA1 and △E were indepen-dent influencing factors of postpartum SUI.The ROC analysis results of the Nomogram model showed that the AUC of the Nomogram model in the model group predicting the occurrence of postpartum SUI was 0.951(95%CI:0.924-0.977).The AUC of the verification group was 0.936(95%CI:0.907-0.964).The Bootstrap method was used for repeated sampling for 1,000 times,and the verification group was used for verification.The calibra-tion curve results showed that the model curve was basically fitted to the diagonal line of the ideal model.The re-sults of decision curve analysis in the model group showed that when the prediction probability threshold was 0.10-0.90,the net benefit of the model in predicting postpartum SUI was the highest.Conclusion:The occur-rence of postpartum SUI is affected by BMI,Ry,Vy and other factors.The Nomogram model is expected to be used to predict postpartum SUI.关键词
超声指标/压力性尿失禁/多因素分析/列线图模型Key words
ultrasound indicators/stress urinary incontinence/multivariate analysis/Nomogram model分类
医药卫生引用本文复制引用
李雪,张贵清,张丽玲,王茜..基于超声指标预测产后压力性尿失禁列线图模型建立与验证[J].广西医科大学学报,2023,40(12):2064-2070,7.基金项目
达州市市级医学科研课题资助项目(No.2019025) （No.2019025）
