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帕金森病患者胸腰筋膜损伤的危险因素及列线图模型的构建

Risk factors of thoracolumbar fascia injury for patients with Parkinson's disease and construction of a nomogram model.

作者信息

Xiong Yitong, Chen Chengfang, Shi Luyao, Yang Yiyao, Zhai Chenjun, Jiang Tao, Ren Zhanyun, Shen Lei

机构信息

Department of neurology, the Yixing People's Hospital, 1588 Road Xincheng, Yixing, Jiangsu, 214200, China.

Department of orthopaedics, the Yixing People's Hospital, 1588 Road Xincheng, Yixing, Jiangsu, 214200, China.

出版信息

BMC Neurol. 2025 Aug 27;25(1):352. doi: 10.1186/s12883-025-04382-3.

Abstract

BACKGROUND

Thoracolumbar fascia injury (TLFI) is common in Parkinson's disease (PD) patients; however, the related risk factors are still controversial, and few studies have focused on clinical prediction models for TLFI. The aim of this study was to investigate the risk factors for TLFI in patients with PD and construct a clinical nomogram prediction model.

METHODS

The clinical data of 351 patients with PD from October 2019 to September 2022 were retrospectively analyzed. MRI images were used to evaluate the presence or absence of TLFI. Binary logistic regression analysis was used to determine the independent risk factors for TLFI in patients with PD. The independent predictors were used as predictors to construct a nomogram model, and the predictive efficacy of the model was evaluated by receiver operating characteristic (ROC) curves and calibration curves (CCs). Decision curve analysis (DCA) was used to evaluate the clinical application value of the model.

RESULTS

A higher UPDRS-III score, a lack of regular exercise, sagittal imbalance, sarcopenia and a low level of albumin were independent risk factors for TLFI in patients with PD. The area under the ROC curve was 0.974, and the CC and the ideal curve fit were good; the DCA. results showed that the model had high net benefits within all thresholds and had high clinical application value.

CONCLUSION

TLFI is closely related to higher a UPDRS-III score, a lack of daily exercise, sagittal imbalance, sarcopenia, and lower albumin levels in patients with PD. Patients with these factors should pay more attention to TLFI prevention and treatment.

摘要

背景

胸腰筋膜损伤(TLFI)在帕金森病(PD)患者中很常见;然而,相关危险因素仍存在争议,且很少有研究关注TLFI的临床预测模型。本研究的目的是调查PD患者发生TLFI的危险因素,并构建临床列线图预测模型。

方法

回顾性分析2019年10月至2022年9月期间351例PD患者的临床资料。采用MRI图像评估TLFI的有无。采用二元逻辑回归分析确定PD患者发生TLFI的独立危险因素。将独立预测因素用作构建列线图模型的预测指标,并通过受试者工作特征(ROC)曲线和校准曲线(CCs)评估模型的预测效能。采用决策曲线分析(DCA)评估模型的临床应用价值。

结果

较高的统一帕金森病评定量表第三部分(UPDRS-III)评分、缺乏规律运动、矢状面失衡、肌肉减少症和低白蛋白水平是PD患者发生TLFI的独立危险因素。ROC曲线下面积为0.974,CC与理想曲线拟合良好;DCA结果显示,该模型在所有阈值范围内均具有较高的净效益,具有较高的临床应用价值。

结论

PD患者的TLFI与较高的UPDRS-III评分、缺乏日常运动、矢状面失衡、肌肉减少症以及较低的白蛋白水平密切相关。具有这些因素的患者应更加关注TLFI的防治。

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