Abstract:

Objective A risk prediction model for pan-vascular disease in patients with type 2 diabetes mellitus was constructed，and the nomogram was drawn and the prediction effect of the model was verified，so as to provide a basis for clinical nurses to identify patients at high risk of pan-vascular disease with T2DM. Methods Using the convenience sampling method，520 patients with Type 2 diabetes mellitus（T2DM） were selected as study participants from the endocrinology，cardiology，neurology，neurosurgery，vascular surgery，and interventional medicine departments of a tertiary A general hospital in Dalian between January and August 2024. Among these，360 participants from January to April 2024 constituted a modeling group，while 160 participants from May to August 2024 formed a validation group. The questionnaire on risk factors of pan-vascular disease in patients with T2DM was used to collect general data and disease-related data，and the influencing factors of pan-vascular disease in patients with T2DM were analyzed by univariate analysis and multivariate logistic regression. Hosmer-Lemeshow was used to test the validity and fit of the model；the Youden index was used to determine the optimal cut-off value of the early warning model；the clinical decision curve graph was used to analyze the clinical utility of the prediction model. Results Ultimately，354 cases were included in the modeling group and 160 cases in the validation group. Logistic regression analysis showed that BMI，duration of diabetes，hypertension，history of previous cardiovascular disease，dyslipidemia，glycosylated hemoglobin and carotid plaque were the risk factors for pan-vascular disease in patients with T2DM（P<0.05）. The results of Hosmer-Lemeshow test showed that χ²=2.615，P=0.956. The external validation results showed that the maximum approximate index was 0.586，the sensitivity of the model was 0.807，the specificity was 0.779，and the area under the ROC curve was 0.863. Conclusion This study establishes and validates a risk prediction model for generalized vascular disease in patients with T2DM，demonstrating good predictive efficacy. It provides a scientific basis for healthcare professionals to early identify and screen

Key words: Type 2 Diabetes, Pan-Vascular Disease, Risk Factors, Risk Prediction Model, Nursing Care

摘要：

目的 构建2型糖尿病（type 2 diabetes mellitus，T2DM）患者泛血管疾病风险预测模型，绘制列线图并验证模型的预测效果，为临床护理人员识别T2DM泛血管疾病高危患者提供依据。 方法 采用便利抽样法，于2024年1—8月选取大连市某三级甲等综合医院内分泌科、心内科、神经内科、神经外科、血管外科、介入科的520例T2DM患者作为调查对象，其中，2024年1—4月的360例为建模组，2024年5—8月的160例为验证组。应用T2DM患者泛血管疾病危险因素调查表收集一般资料及疾病相关资料，通过单因素分析和多因素Logistic回归分析探讨T2DM患者泛血管疾病的影响因素，建立风险预测模型，绘制列线图，通过受试者工作特征（receiver operator characteristic，ROC）曲线下面积、Hosmer-Lemeshow对该模型进行效度和拟合度的检验，采用约登指数确定模型的最佳截断值，通过临床决策分析曲线评价模型的预测效果。 结果 最终建模组纳入354例、验证组纳入160例。Logistic回归分析结果显示，BMI、糖尿病病程、高血压、既往心血管疾病病史、血脂异常、糖化血红蛋白、颈动脉斑块是T2DM患者泛血管疾病的影响因素（P<0.05）。Hosmer-Lemeshow检验结果显示，χ²=2.615，P=0.956。外部验证结果显示，最大约登指数为0.586，模型灵敏度为0.807，特异度为0.779，ROC曲线下面积为0.863。 结论 该研究构建的T2DM患者泛血管疾病风险预测模型具有良好的预测效能，可为医护人员早期识别和筛查T2DM泛血管疾病高风险患者提供科学依据。

关键词: 2型糖尿病, 泛血管疾病, 危险因素, 风险预测模型, 护理