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失代偿期肝硬化患者腹水并发症的危险因素:逻辑回归与预测模型

Ascites complications risk factors of decompensated cirrhosis patients: logistic regression and prediction model.

作者信息

Zheng Xiaolong, Wei Wei

机构信息

The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

出版信息

BMC Gastroenterol. 2025 May 22;25(1):397. doi: 10.1186/s12876-025-04002-x.

Abstract

OBJECTIVE

The study mainly aim at exploring the ascites risk factors among decompensated cirrhosis patients via constructing the prediction model of ascites incidence.

METHODS

Here, we recruited 148 decompensated cirrhosis patients for analysis, their laboratory tests and complications recorded. T-test, chi-square test, single-factor logistic regression, multi-factor logistic regression, and nomogram model were used to investigate the ascites occurred factors in decompensated cirrhosis patients with ascites. To validate the data analysis results, we applied the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) to evaluate the discrimination, calibration, and clinical usefulness of the prediction model, respectively.

RESULTS

Serum creatinine levels were higher in the cirrhotic ascites group than in the non-ascites group. The ascites group had lower albumin and serum sodium levels, as well as a lower incidence of variceal bleeding and varicose veins compared to the non-ascites group.

CONCLUSION

Varicose veins, variceal bleeding, and serum sodium levels are significant factors contributing to ascites development in cirrhosis. Furthermore, decreased serum albumin and elevated creatinine levels are important indicators of poor prognosis. Nomograms can improve clinicians' informed decision-making for patients with decompensated cirrhosis, ultimately reducing ascites risk.

摘要

目的

本研究主要旨在通过构建腹水发生率预测模型来探索失代偿期肝硬化患者的腹水危险因素。

方法

我们招募了148例失代偿期肝硬化患者进行分析,记录他们的实验室检查和并发症情况。采用t检验、卡方检验、单因素逻辑回归、多因素逻辑回归和列线图模型来研究失代偿期肝硬化腹水患者发生腹水的因素。为验证数据分析结果,我们应用受试者工作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)分别评估预测模型的辨别力、校准度和临床实用性。

结果

肝硬化腹水组的血清肌酐水平高于非腹水组。与非腹水组相比,腹水组的白蛋白和血清钠水平较低,静脉曲张出血和静脉曲张的发生率也较低。

结论

静脉曲张、静脉曲张出血和血清钠水平是肝硬化腹水发生的重要因素。此外,血清白蛋白降低和肌酐水平升高是预后不良的重要指标。列线图可以改善临床医生对失代偿期肝硬化患者的知情决策,最终降低腹水风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55b1/12100819/f4f8602ef222/12876_2025_4002_Fig1_HTML.jpg

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