目的 基于贝叶斯网络模型探讨糖尿病肾病患者贫血发生的可能因素及性别差异.方法 将 2020 年 6月至 2023 年 6 月于我院接受治疗的 224 例糖尿病肾病患者作为研究对象,根据是否贫血将患者分为贫血组(98 例)和非贫血组(126 例).对不同性别糖尿病肾病患者贫血相关指标进行比较;比较两组糖尿病肾病患者临床资料,采用多因素logistic回归分析糖尿病肾病患者贫血发生的影响因素.通过R软件构建贝叶斯网络模型,并进行模型的推理预测;通过ROC曲线和校准曲线对模型的效能进行验证.结果 男性患者 Hb、RBC和 HCT显著高于女性患者;MCV、MCH 和MCHC显著低于女性患者,差异具有统计学意义(P<0.05).性别、糖尿病病程、肾病分期、ALB、CHE、eGFR和HbA1c均为影响糖尿病肾病患者贫血发生的独立危险因素(P<0.05);训练集和验证集ROC曲线和校准曲线结果均显示贝叶斯网络预测模型具有较好的区分度和准确性.结论 性别、糖尿病病程、肾病分期、ALB、CHE、eGFR和HbA1c均为影响糖尿病肾病患者贫血发生的独立危险因素,并且患者的贫血相关指标具有一定的性别差异.
Objective Probing into possible factors and gender differences of anemia in patients with diabetes nephropathy based on Bayesian network model.Methods 224 patients with diabetes nephropathy who were treated in Ningde City hospital from June 2020 to June 2023 were taken as the research objects,patients were divided into an anemia group(98 cases)and a non anemia group(126 cases)based on whether they were anemic.Comparison of anemia related indicators in diabetes nephropathy patients of different sexes.Comparison of clinical data between two groups of patients with diabetes nephropathy.Multivariate logistic regression was used to analyze the influencing factors of anemia in patients with diabetes nephropathy.Build a Bayesian network model using R software and perform inference and prediction of the model.The effectiveness of the model was verified by receiver operating characteristic and calibration curve.Results Male patients showed significantly higher levels of Hb,RBC,and HCT compared to female patients;MCV,MCH,and MCHC were significantly lower than those in female patients,with statistically significant differences(P<0.05).Sex,course of diabetes,stage of kidney disease,ALB,CHE,eGFR and HbA1c were independent risk factors for anemia in patients with diabetes nephropathy(P<0.05).The results of receiver operating characteristic and calibration curve of training set and verification set show that the Bayesian network prediction model has good discrimination and accuracy.Conclusion Sex,course of diabetes,stage of kidney disease,ALB,CHE,eGFR and HbA1c are independent risk factors for anemia in patients with diabetes nephropathy.There are certain gender differences in anemia related indicators among patients.