数字中医药（英文）2025，Vol.8Issue(2)：174-182,9.DOI:10.1016/j.dcmed.2025.05.006
基于脉图参数的H型高血压风险预测列线图模型构建与验证
Development and validation of a nomogram model for predicting the risk of H-type hypertension with pulse diagram parameters
摘要
Abstract
Objective To develop an onset risk prediction nomogram for patients with homocysteine-type(H-type)hypertension(HTH)based on pulse diagram parameters to assist early clinical prediction and diagnosis of HTH. Methods Patients diagnosed with essential hypertension and admitted to Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shang-hai Hospital of Traditional Chinese Medicine,and Shanghai Hospital of Integrated Tradition-al Chinese and Western Medicine from July 6th 2020 to June 16th 2021,and from August 11th 2023 to January 22nd 2024,were enrolled in this retrospective research.The baselines and clinical biochemical indicators of patients were collected.The SMART-I TCM pulse instru-ment was applied to gather pulse diagram parameters.Multivariate logistic regression was adopted to analyze the risk factors for HTH.RStudio was employed to construct the nomo-gram model,receiver operating characteristic(ROC)curve,and calibration curve(bootstrap self-sampling 200 times),and clinical decision curve were drawn to evaluate the model's dis-crimination and clinical effectiveness. Results A total of 168 hospitalized patients with essential hypertension were selected and di-vided into non-HTH group(n=29)and HTH group(n=139).Compared with non-HTH group,HTH group had a lower body mass index(BMI),and higher proportions of male pa-tients and drinkers(P<0.05).The ventricular wall thickening(VWT)could not be deter-mined.The proportions of left common carotid intima-media wall thickness(LCCIMWT)and serum creatinine(SCR)were higher in HTH group(P<0.05).The pulse diagram parameter As was significantly higher,and H4/H1 and T1/T were lower in HTH group(P<0.05).Gender,al-cohol consumption,serum creatinine,and the pulse diagram parameter H4/H1 were identi-fied as independent risk factors for HTH(P<0.05).The nomogram's area under the ROC curve(AUC)was 0.795[95%confidence interval(CI):(0.706 6,0.882 8)],with a specificity of 0.724 and sensitivity of 0.799.After 200 times repeated bootstrap self-samplings,the calibra-tion curve showed that the simulated curve fits well with the actual curve(x2=9.500 2,P=0.301 9).The clinical decision curve indicated that the nomogram's applicability was optimal when the threshold for predicting HTH was between 0.38 and 1.00. Conclusion The nomogram model could be valuable for predicting the onset risk of HTH and pulse diagram parameters can facilitate early screening and prevention of HTH.关键词
H型高血压/同型半胱氨酸/列线图/脉图参数/预测模型Key words
H-type hypertension/Homocysteine/Nomogram/Pulse diagram parameters/Prediction model引用本文复制引用
王斯曼,张梦楚,尧明慧,解天骁,郭睿,王忆勤,燕海霞..基于脉图参数的H型高血压风险预测列线图模型构建与验证[J].数字中医药（英文）,2025,8(2):174-182,9.基金项目
National Natural Science Foundation of China(81973749 and 8143594),and State Administration of Traditional Chinese Medicine High-level Chinese Medicine Key Dis-cipline Construction Project(zyyzdxk-2023069). （81973749 and 8143594）
