中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (04): 347-352.doi: 10.3969/j.issn.1671-4091.2026.04.014

• 护理研究 • 上一篇    

腹膜透析患者发生抑郁列线图预测模型的构建与验证

张 馨    徐鹏飞    李 姁    余卫卫    吴 言    王晓燕   

  1. 210009 南京，东南大学附属中大医院1肾内科 4护理部
    210008 南京，2南京大学医学院附属鼓楼医院肾内科
    211200 南京，3南京市溧水区人民医院肾内科
    210009 南京，5东南大学医学院护理学系
  • 收稿日期:2025-08-28 修回日期:2025-12-25 出版日期:2026-04-12 发布日期:2026-04-12
  • 通讯作者: 王晓燕 E-mail:xywang2023@seu.edu.cn

Construction and validation of a nomogram prediction model for depression in peritoneal dialysis patients

ZHANG Xin, XU Peng-fei, LI Xu, YU Wei-wei, WU Yan, WANG Xiao-yan   

  1. Department of Nephrology and 4Department of Nursing, Zhongda Hospital, Southeast University, Nanjing 210009, China; 2Department of Nephrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China; 3Department of Nephrology, Nanjing Lishui People's Hospital, Nanjing 211200, China; 5Department of Nursing, School of Medicine, Southeast University, Nanjing 210009, China
  • Received:2025-08-28 Revised:2025-12-25 Online:2026-04-12 Published:2026-04-12
  • Contact: 210009 南京，东南大学附属中大医院4护理部；210009 南京，5东南大学医学院护理学系 E-mail:xywang2023@seu.edu.cn

摘要： 目的 探讨腹膜透析(peritoneal dialysis，PD)患者发生抑郁的危险因素，构建列线图预测模型。 方法  选择2023年10月—2024年6月在东南大学附属中大医院、南京大学医学院附属鼓楼医院和南京市溧水区人民医院就诊的PD患者纳入建模集，另选取2024年7月—2024年10月就诊的PD患者纳入验证集，采用二元Logistic回归确定抑郁的影响因素，构建抑郁列线图预测模型并验证。 结果 建模集、验证集分别纳入233、66例患者。建模集的焦虑评分(OR=27.579，95%CI：12.041～63.165，P＜0.001)、工作状况(OR=0.351，95%CI：0.147～0.834，P=0.018)、认知功能评分(OR=0.386，95%CI：0.165～0.902，P=0.028)、身体健康综合指数(OR=0.940，95%CI：0.899～0.983，P=0.007)、超敏C反应蛋白(OR=1.024，95%CI：1.002～1.046，P=0.030)、甲状旁腺激素(OR=1.001，95%CI：1.000～1.003，P=0.022)是PD患者发生抑郁的预测因子。建模集的受试者工作特征曲线下面积(area under curve，AUC)为0.893(95%CI：0.852～0.934)，灵敏度为76.4%，特异度为90.2%；验证集的AUC为0.926(95%CI：0.866～0.985)，灵敏度为96.0%，特异度为82.9%。 结论  PD患者发生抑郁的列线图预测模型具有良好临床实用性，可帮助医护人员识别抑郁高风险人群。

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Abstract: 【Abstract】 Objective To explore the risk factors for depression in peritoneal dialysis (Peritoneal Dialysis, PD) patients and construct a nomogram prediction model. Methods A total of 233 PD patients were selected from Zhongda Hospital Southeast University, Nanjing Drum Tower Hospital and Nanjing Lishui People's Hospital between October 2023 and June 2024 to form the modeling set, while 66 PD patients from July to October 2024 were included in the validation set. Binary logistic regression analysis was employed to identify risk factors for depression, and a nomogram prediction model for depression was constructed and validated.. Results In the modeling set, the anxiety scores (OR=27.579, 95%CI: 12.041~63.165, P＜0.001), work status (OR=0.351, 95%CI: 0.147~0.834, P=0.018), cognitive function scores (OR=0.386, 95%CI: 0.165~0.902, P=0.028), physical health composite index (OR=0.940, 95%CI: 0.899~0.983, P=0.007), hypersensitive C-reactive protein level (OR=1.024, 95%CI: 1.002~1.046, P=0.030), and parathyroid hormone (OR=1.001, 95%CI: 1.000~1.003, P=0.022) were predictive factors for depression in PD patients. The Area Under Curve (AUC) of the Receiver Operating Characteristic Curve for the modeling set was 0.893 (95% CI: 0.852~0.934), with a sensitivity of 76.4% and a specificity of 90.2%. The AUC for the validation set was 0.926 (95% CI: 0.866~0.985), with a sensitivity of 96.0% and a specificity of 82.9%. Conclusion The nomogram prediction model for depression in PD patients demonstrates good clinical utility, aiding health care workers in identifying individuals at high risk of depression.

Key words: Peritoneal dialysis, Depression, Prediction model, Risk factor

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