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基于超声的列线图模型构建及验证,用于预测慢性阻塞性肺疾病患者的吞咽困难

Construction and validation of an ultrasound-based nomogram model for predicting dysphagia in patients with chronic obstructive pulmonary disease.

作者信息

Su Shanshan, Su Qichen, Zhong Huohu, Lyu Guorong, Li Yuanzhe, Wang Yi, Xu Zhirong

机构信息

Department of Ultrasound in Medicine, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.

Department of CT/MRI, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.

出版信息

Front Med (Lausanne). 2025 Jul 8;12:1533165. doi: 10.3389/fmed.2025.1533165. eCollection 2025.


DOI:10.3389/fmed.2025.1533165
PMID:40697922
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12279852/
Abstract

INTRODUCTION: Dysphagia is common in chronic obstructive pulmonary disease (COPD), prompting the need for predictive models for this condition. In this study, we aimed to develop a nomogram model for dysphagia prediction in patients with COPD. METHODS: Data from 300 patients with COPD were divided into the training ( = 210) and validation ( = 90) cohorts. Independent risk factors for dysphagia were identified using logistic regression and used to construct a nomogram model. The model's predictive efficacy, accuracy, and clinical utility were evaluated using receiver operating characteristic curve analysis, calibration, decision curve analysis, and clinical impact curves. RESULTS: Hypoglossal-hyoid shortening rate, hyoid-larynx shortening approximation distance, chin time of movement of the genioglossus, and distance of movement of the genioglossus were identified as independent risk factors. The nomogram exhibited areas under the curve of 0.834 and 0.804 in the training and validation cohorts, respectively, indicating good predictive efficacy and calibration. CONCLUSION: The nomogram model effectively predicts dysphagia occurrence in patients with COPD, providing a valuable tool for risk assessment.

摘要

引言:吞咽困难在慢性阻塞性肺疾病(COPD)中很常见,因此需要针对这种情况建立预测模型。在本研究中,我们旨在开发一种用于预测COPD患者吞咽困难的列线图模型。 方法:将300例COPD患者的数据分为训练队列(n = 210)和验证队列(n = 90)。使用逻辑回归确定吞咽困难的独立危险因素,并用于构建列线图模型。使用受试者工作特征曲线分析、校准、决策曲线分析和临床影响曲线评估模型的预测效能、准确性和临床实用性。 结果:舌下-舌骨缩短率、舌骨-喉缩短近似距离、颏舌肌运动的颏部时间和颏舌肌运动距离被确定为独立危险因素。该列线图在训练队列和验证队列中的曲线下面积分别为0.834和0.804,表明具有良好的预测效能和校准。 结论:列线图模型可有效预测COPD患者吞咽困难的发生,为风险评估提供了有价值的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/456e3fdf52e3/fmed-12-1533165-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/8198498f6eac/fmed-12-1533165-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/a0d31daee7d0/fmed-12-1533165-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/6bd96447c494/fmed-12-1533165-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/d35fe77bd511/fmed-12-1533165-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/6674a660c1bd/fmed-12-1533165-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/5484e5c0ae86/fmed-12-1533165-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/85c8335e9c41/fmed-12-1533165-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/e32c9f3e8029/fmed-12-1533165-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/456e3fdf52e3/fmed-12-1533165-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/8198498f6eac/fmed-12-1533165-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/a0d31daee7d0/fmed-12-1533165-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/6bd96447c494/fmed-12-1533165-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/d35fe77bd511/fmed-12-1533165-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/6674a660c1bd/fmed-12-1533165-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/5484e5c0ae86/fmed-12-1533165-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/85c8335e9c41/fmed-12-1533165-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/e32c9f3e8029/fmed-12-1533165-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fe/12279852/456e3fdf52e3/fmed-12-1533165-g009.jpg

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本文引用的文献

[1]
Imaging swallowing function and the mechanisms driving dysphagia in inclusion body myositis.

Clin Exp Rheumatol. 2024-2

[2]
Risk estimation for postoperative nausea and vomiting: development and validation of a nomogram based on point-of-care gastric ultrasound.

BMC Anesthesiol. 2023-11-30

[3]
Assessing Swallowing Dysfunction Aggravation in Chronic Obstructive Pulmonary Disease Patients Using Ultrasonic Measurements With Swallowing Movement Parameters.

J Ultrasound Med. 2024-3

[4]
Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary.

Eur Respir J. 2023-4

[5]
From past to future: Bibliometric analysis of global research productivity on nomogram (2000-2021).

Front Public Health. 2022

[6]
Chronic obstructive pulmonary disease.

Lancet. 2022-6-11

[7]
Clinical Practice Patterns of Speech-Language Pathologists Delivering Dysphagia Services to Persons with COPD: Analysis of Survey Outcomes.

Semin Speech Lang. 2021-11

[8]
Ultrasound: an emerging modality for the dysphagia assessment toolkit?

Curr Opin Otolaryngol Head Neck Surg. 2021-6-1

[9]
Dysphagia in Older Adults.

Mayo Clin Proc. 2021-2

[10]
Repetitive Saliva Swallowing Test Predicts COPD Exacerbation.

Int J Chron Obstruct Pulmon Dis. 2019-12-4

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