未经证实:威尔逊病,也被称为肝豆状核变性,是一种罕见的人类常染色体隐性遗传铜代谢障碍。临床表现多样,诊断和治疗经常延迟。本研究的目的是建立一种新的威尔逊病预测诊断模型,并通过对小创伤的多元回归分析评价其预测效果。准确性好,低成本,和可量化的血清学指标,为了及早发现威尔逊病,提高诊断率,并明确治疗方案。
UNASSIGNED:回顾性分析2003年1月至2022年5月云南省第一人民医院收治的127例Wilson病患者作为实验组,73例血清学指标正常但未确诊为Wilson病的患者。采用SPSS26.0版软件进行单因素筛选,采用多元二元logistic回归分析筛选出独立因素。采用R版本4.1.0软件对所包含的独立影响因素建立直观的列线图预测模型。通过计算一致性指数(C指数)并绘制校准曲线,评估和量化了列线图预测模型的准确性。同时,计算列线图预测模型的曲线下面积(AUC)和莱比锡评分的受试者工作特征曲线(ROC),以比较列线图模型和当前莱比锡评分对威尔逊病的预测能力.
未经批准:丙氨酸氨基转移酶(ALT),天冬氨酸转氨酶(AST),碱性磷酸酶(AKP),白蛋白(ALB),尿酸(UA),血清钙(Ca),血清磷(P),血红蛋白(HGB)与Wilson病的发生密切相关(p<0.1)。威尔逊病的预测模型包含七个独立的预测因子:ALT,AST,AKP,ALB,UA,Ca,预测模型的AUC值为0.971,C指数值为0.972。校准曲线与理想曲线很好地拟合。列线图预测模型对Wilson病的发生有较好的预测效果,绘制Leipzig评分的ROC曲线,并计算AUC值。Leipzig评分的AUC为0.969,说明预测模型和评分系统具有预测价值,列线图预测模型对中心的研究对象有较好的预测效果。
未经批准:ALT,AST,AKP,ALB,UA,Ca,P是威尔逊病的独立预测因子,并且可以用作早期预测因子。基于列线图预测模型,最佳阈值为0.698,是判断Wilson病的重要参考指标。与莱比锡的得分相比,列线图预测模型具有较高的敏感性和特异性,具有较好的临床应用价值。
UNASSIGNED: Wilson\'s disease, also known as hepatolenticular degeneration, is a rare human autosomal recessive inherited disorder of copper metabolism. The clinical manifestations are diverse, and the diagnosis and treatment are often delayed. The purpose of this study is to establish a new predictive diagnostic model of Wilson\'s disease and evaluate its predictive efficacy by multivariate regression analysis of small trauma, good accuracy, low cost, and quantifiable serological indicators, in order to identify Wilson\'s disease early, improve the diagnosis rate, and clarify the treatment plan.
UNASSIGNED: A retrospective analysis was performed on 127 patients with Wilson\'s disease admitted to the First People\'s Hospital of Yunnan Province from January 2003 to May 2022 as the experimental group and 73 patients with normal serological indicators who were not diagnosed with Wilson\'s disease. SPSS version 26.0 software was used for single factor screening and a multivariate binary logistic regression analysis to screen out independent factors. R version 4.1.0 software was used to establish an intuitive nomogram prediction model for the independent influencing factors included. The accuracy of the nomogram prediction model was evaluated and quantified by calculating the concordance index (C-index) and drawing the calibration curve. At the same time, the area under the curve (AUC) of the nomogram prediction model and the receiver operating characteristic (ROC) curve of the Leipzig score was calculated to compare the predictive ability of the nomogram model and the current Leipzig score for Wilson\'s disease.
UNASSIGNED: Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AKP), albumin (ALB), uric acid (UA), serum calcium (Ca), serum phosphorus (P), and hemoglobin (HGB) are closely related to the occurrence of Wilson\'s disease (p < 0.1). The prediction model of Wilson\'s disease contains seven independent predictors: ALT, AST, AKP, ALB, UA, Ca, and P. The AUC value of the prediction model was 0.971, and the C-index value was 0.972. The calibration curve was well fitted with the ideal curve. The nomogram prediction model had a good predictive effect on the occurrence of Wilson\'s disease; the ROC curve of Leipzig score was drawn, and the AUC value was calculated. The AUC of the Leipzig score was 0.969, indicating that the prediction model and the scoring system had predictive value, and the nomogram prediction model had a better predictive effect on the research objects of the center.
UNASSIGNED: ALT, AST, AKP, ALB, UA, Ca, and P are independent predictors of Wilson\'s disease, and can be used as early predictors. Based on the nomogram prediction model, the optimal threshold was determined to be 0.698, which was an important reference index for judging Wilson\'s disease. Compared with the Leipzig score, the nomogram prediction model has a relatively high sensitivity and specificity and has a good clinical application value.