摘要
目的:构建针灸对早发性卵巢功能不全(POI)患者妊娠结局影响的列线图临床预测模型,为针灸改善POI患者妊娠结局提供预测方法。方法:从国际针灸病例注册登记研究平台(IPRPAM)导出真实世界POI患者针灸诊疗数据,采用最小绝对收缩选择算子(LASSO)回归法筛选对接受针灸治疗POI患者妊娠结局的影响较大的因素;以LASSO回归筛选的因素为自变量,随访时间和妊娠结局为时间相关的因变量,构建多因素Cox比例风险回归模型,以列线图可视化方式呈现临床预测模型。结果:共纳入90例POI患者,年龄、受教育程度、既往流产史、基础FSH水平、基础AFC、针灸频次6个变量为影响POI患者针灸后是否妊娠的影响因素,calibration校正曲线计算该预测模型具有较好的准确性和校准度。结论:LASSO-Cox模型构建针灸对POI患者妊娠结局影响的临床预测模型具有较好的临床应用价值。
Objective:To establish a nomogram clinical prediction model of the influence of acupuncture-moxibustion on pregnancy outcome in patients with premature ovarian insufficiency(POI),so as to provide prediction methods for acupuncturemoxibustion to improve pregnancy outcome of patients with POI.Methods:The clinical data on acupuncture-moxibustion treatment POI in the real world through the International Patient Registry Platform of Acupuncture-Moxibustion(IPRPAM)were collected.The least absolute shrink and selection operator(LASSO)regression method was used to screen the influential factors on pregnancy outcome of patients with POI treated by acupuncture-moxibustion;the factors screened by LASSO regression were used as independent variables,and the follow-up time and pregnancy outcome were time-related dependent variables.The multivariate Cox proportional hazard regression model was established,and the clinical prediction model was presented in nomogram visualization.Results:A total of 90 patients with POI were included.Age,education level,previous abortion history,basic FSH level,basic AFC and acupuncture-moxibustion frequency were the influencing factors of pregnancy in patients with POI after acupuncture-moxibustion.The calibration curve calculation showed that the prediction model had good accuracy and calibration.Conclusion:The clinical prediction model of the influence of acupuncture and moxibustion on pregnancy outcome of patients with POI has a good clinical application value.
作者
丰逸轩
杨会生
房繄恭
刘保延
勾明会
刘思雨
郝鸣昭
FENG Yi-xuan;YANG Hui-sheng;FANG Yi-gong;LIU Bao-yan;GOU Ming-hui;LIU Si-yu;HAO Ming-zhao(Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100700,China;Clinic of Premature Ovarian Failure,Acupuncture and Moxibustion Hospital of China Academy of Chinese Medical Sciences,Beijing 100700,China;China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2021年第4期1979-1983,共5页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家重点研发计划项目(No.2017YFC1703603,No.2017YFC1703600)。
