保健医学研究与实践2026，Vol.23Issue(1)：23-29,7.DOI:10.11986/j.issn.1673-873X.2026.01.05
乙型肝炎肝硬化伴腹水患者衰弱现状及影响因素分析
Current status survey and influencing factors of frailty in patients with hepatitis B cirrhosis complicated by ascites
摘要
Abstract
Objective To investigate the current status and influencing factors of frailty in patients with hepatitis B cirrhosis complicated by ascites,and to construct and validate a nomogram model,providing references for clinical treatment.Methods A total of 500 pa-tients with hepatitis B cirrhosis complicated by ascites admitted to Tangdu Hospital,Air Force Medical University from March 2022 to March 2025 were enrolled.Based on the occurrence of frailty,patients were assigned to non-frailty(n=362)and frailty groups(n=138).Clinical data were collected for all patients.Logistic regression analysis was used to identify factors influencing frailty.The"ms"package in R software was employed to construct a nomogram model.Internal and external validation of the model was performed by plotting calibration curves,conducting Hosmer-Lemeshow goodness-of-fit tests,plotting receiver operating characteristic(ROC)curves,and performing decision curve analysis(DCA).Results Univariate analysis showed statistically significant differences between the two groups in age,body mass index(BMI),Child-Pugh score,duration of cirrhosis,prothrombin time(PT),white blood cell count(WBC)level,cholinesterase(CHE)level,and Barthel Index score(P<0.05).Multivariate logistic regression analysis identified age,BMI,duration of cirrhosis,Child-Pugh score,PT,WBC,CHE,and Barthel Index were influencing factors for frailty in patients with hepatitis B cirrhosis complicated by ascites(P<0.05).The ROC curve showed an area under the curve(AUC)of 0.95(95%CI:0.93-0.97),indicating good predictive performance of the model.The Hosmer-Lemeshow goodness-of-fit test suggested that the fit-ted probability values were essentially consistent with the actual probability values(χ2=3.937,P=0.863).DCA demonstrated that the net benefit for patients was higher than that of the two extreme curves,and the model could yield better clinical benefit when the threshold probability ranged from 0.02 to 1.00.Conclusion Age,BMI,duration of cirrhosis,Child-Pugh score,PT,activities of daily living,CHE,and WBC are influencing factors for frailty in patients with hepatitis B cirrhosis complicated by ascites.The nomogram model constructed based on these factors demonstrates good efficacy in predicting the occurrence of frailty in these patients.关键词
慢性乙型肝炎/肝硬化/腹水/衰弱/影响因素Key words
Chronic hepatitis B/Cirrhosis/Ascites/Frailty/Influencing factors分类
医药卫生引用本文复制引用
刘庆珍,党肖,汪春付,马颖颖,王李晶子,张岚,胡进佩..乙型肝炎肝硬化伴腹水患者衰弱现状及影响因素分析[J].保健医学研究与实践,2026,23(1):23-29,7.基金项目
陕西省重点研发计划项目(2022SF-186) （2022SF-186）
空军军医大学第二附属医院科研课题项目(HLKYKT-202505). （HLKYKT-202505）
