| 陈宇鲜,翟志远,吴艳云.基于预后营养指数构建预测帕金森病严重程度的列线图模型和评价[J].安徽医药,2025,29(10):1993-1998. |
| 基于预后营养指数构建预测帕金森病严重程度的列线图模型和评价 |
| Value of prognostic nutritional index in predicting the severity of Parkinson's disease: construction of a model and evaluation |
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| DOI：10.3969/j.issn.1009-6469.2025.10.016 |
| 中文关键词: 帕金森病 预后营养指数 病人病情 列线图 预测模型 |
| 英文关键词: Parkinson's disease Prognostic nutritional index Patient acuity Nomogram Prediction model |
| 基金项目:江苏省卫生健康委科研项目( Z2023011) |
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| 中文摘要: |
| 目的探讨预后营养指数( PNI)对帕金森病病人病情严重程度的预测价值，并构建列线图预测模型和评价。方法选取 2019年 1月至 2022年 10月于淮安市第一人民医院就诊的原发性帕金森病病人 144例为研究对象，并纳入同期 138例体检者作为健康组，比较两组间临床资料差异，另根据 Hoehn-Yahr分期( H-Y)将帕金森病病人分为 H-Y早期( 1~2.5期)、 H-Y中晚期(3~5期)两组，进行两组间差异比较，采用二元 logistic回归分析寻找 H-Y中晚期的独立影响因素，并构建列线图预测模型和验证。结果帕金森病组的中性粒细胞计数［3.6(2.8，4.4)×109/L比 3.2(2.7，4.0)×109/L］显著高于健康组，帕金森病组的淋巴细胞计数［1.5(1.2，1.8)×109/L比 2.0(1.6，2.5)×109/L］、血小板计数［195.0(158.5，233.5)×109/L比 204.5(175.8，246.3)×109/L］、血清白蛋白［4.22(3.96，4.45)g/L比 4.75(4.56，4.90)g/L］和 PNI［49.8(46.7，53.0)比 57.0(55.2，59.9)］显著低于健康组。 H-Y中晚期组的年龄［70.0(64.3，74.8)岁比 66.5(59.0，73.0)岁］、病程［6.0(4.0，8.0)年比 2.0(1.0，4.8)年］、 LED［650.0(462.0，799.5)mg比 450.0 |
| 英文摘要: |
| Objective To explore the value of prognostic nutritional index (PNI) in predicting the severity of Parkinson's disease(PD), and to construct a nomogram prediction model and evaluation.Methods A total of 144 patients with primary PD who were seenat Huai'an First People's Hospital between January 2019 and October 2022 were enrolled as study subjects, and 138 healthy peoplewho underwent physical examination during the same period were included as the healthy control group. The differences in clinical da-ta between the two groups were compared, and PD patients were divided into early Hoehn-Yahr (H-Y) group (1-2.5 stage) and middle and late H-Y group (3-5 stage) according to H-Y stage, and the differences between the two groups were compared. Binary logistic re-gression analysis was used to find the independent influencing factors for the middle and late stages of H-Y, and a nomogram prediction model was constructed and verified.Results Compared with healthy controls, the PD group exhibited significantly higher neutrophil counts [3.6 (2.8, 4.4) ×10./L vs. 3.2 (2.7, 4.0) ×10./L] but significantly lower lymphocyte counts [1.5 (1.2, 1.8) ×10./L vs. 2.0 (1.6, 2.5) × 10./L], platelet counts [195.0 (158.5, 233.5) ×10./L vs. 204.5 (175.8, 246.3) ×10 ./L], serum albumin levels [4.22 (3.96, 4.45)g/L vs. 4.75 (4.56,4.90) g/L], and PNI values [49.8 (46.7, 53.0) vs. 57.0 (55.2, 59.9)]. When stratified by disease severity, patients in middle-late H-Y stages demonstrated significantly greater age [70.0 (64.3, 74.8) vs. 66.5 (59.0, 73.0) years], disease duration [6.0 (4.0, 8.0) vs. 2.0 (1.0, 4.8) years], levodopa equivalent dose (LED) [650.0 (462.0, 799.5) mg/day vs. 450.0 (350.0, 600.0) mg/day], and Unified Parkin-son's Disease Rating Scale Part Ⅲ (UPDRSⅢ) scores [(51.35 ± 12.13) points vs. (29.64 ± 11.82) points], along with significantly re-duced serum albumin and PNI compared to early-stage H-Y patients. Course of disease and UPDRSⅢ were risk factors for the middle and late H-Y in PD patients; PNI was a protective factor for advanced H-Y stage in PD patients. The nomogram model for individual-ized prediction of the severity of PD patients based on the course of disease, UPDRSⅢ and PNI had good discrimination, clinical con-sistency and high clinical practicability.Conclusions Decreased PNI, increased duration of disease and increased UPDRSⅢ are inde-pendent risk factors for advanced H-Y stage in PD patients. The nomogram model based on PNI and other indicators can effectively pre-dict the severity of PD patients, which has certain clinical predictive value. |
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