实用临床医药杂志2025，Vol.29Issue(13)：55-60,65,7.DOI:10.7619/jcmp.20250903
患者报告结局联合血液学指标对溃疡性结肠炎患者中重度内镜下活动的预测价值
Predictive value of patient-reported outcomes combined with hematological indicators for moderate-to-severe endoscopic activity in patients with ulcerative colitis
摘要
Abstract
Objective To analyze the predictive value of patient-reported outcomes(PRO)com-bined with hematological indicators for moderate-to-severe endoscopic activity in patients with ulcera-tive colitis(UC).Methods Clinical data of UC patients were retrospectively collected,including PRO,hematological parameters and endoscopic findings.Based on the Mayo endoscopic score,pa-tients were divided into remission and mild activity group(＜2 points)and moderate-to-severe activity group(≥ 2 points).Independent influencing factors for moderate-to-severe endoscopic activity were screened through multivariate Logistic regression analysis,and a binary Logistic regression model was constructed.The receiver operating characteristic(ROC)curve was used to evaluate the discriminato-ry ability of the predictive model.The calibration of the model was assessed using calibration curves and the Spiegelhalter Z-test,and the model's performance was further validated in an external valida-tion cohort.Results Rectal bleeding(RB),C-reactive protein/albumin(CAR)and erythrocyte sed-imentation rate(ESR)were independent influencing factors for moderate-to-severe endoscopic activity(P＜0.05).The area under the curve(AUC)of the nomogram predictive model constructed based on the logistic regression analysis results was 0.848(95％CI,0.798 to 0.900),with sensitivity of 76.6％and specificity of 79.6％.In the external validation cohort,the model's AUC was 0.778(95％CI,0.699 to 0.857),and there was no statistically significant difference compared with the AUC of the training cohort model(P＞0.05).In both the training and validation cohorts,the Spiegelhalter Z-test results indicated that the model had good goodness-of-fit(P＞0.05).Conclu-sion RB,CAR and ESR are independent influencing factors for moderate-to-severe endoscopic ac-tivity in UC patients.The combination of RB,CAR and ESR has high predictive value for moderate-to-severe endoscopic activity in UC patients,with good discriminatory and calibration abilities.关键词
患者报告结局/血液学指标/溃疡性结肠炎/中重度内镜下活动/C反应蛋白/白蛋白/血沉/便血/列线图预测模型Key words
patient-reported outcomes/hematological indicators/ulcerative colitis/moder-ate-to-severe endoscopic activity/C-reactive protein/albumin/erythrocyte sedimentation rate/rectal bleeding/predictive nomogram分类
医药卫生引用本文复制引用
李彩敏,李文倩,侯思聪,肖炜明,陈洁,王梅..患者报告结局联合血液学指标对溃疡性结肠炎患者中重度内镜下活动的预测价值[J].实用临床医药杂志,2025,29(13):55-60,65,7.基金项目
国家自然科学基金面上项目(81873866) （81873866）
江苏省研究生科研与实践创新计划项目(SJCX23_2033) （SJCX23_2033）
扬州市软科学研究计划项目(YZ2022273) （YZ2022273）
