抗结核药物肝损伤影响因素分析与预测模型构建

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【中图分类号】R52 【文献标识码】A

【Abstract】 Objective To analyze the influencing factors for anti-tuberculosis druginduced liver injury （ATB-DILI） and construct a prediction model. Methods Clinical data were retrospectively collected from patients who received anti-tuberculosis （TB） treatment and completed follow-up from January 2019 to October 2022 at Rugao People's Hospital.Patients from January 2019 and December 2019 were included in the training set，and patients from January 2020 to October 2022 were included in the testing set. A nomogram was constructed，and its predictive performance was evaluated using the receiver operating characteristic （ROC） curve and its area under the curve （AUC）， calibration curve，decision curve analysis，and clinical impactcurve and verified inthe testing set.Packages such as DynNom were used to publish nomograms to the network and develop dynamic nomograms that predicted ATB-DILI risk. Results A total of 1，396 TB patients were included， with an ATB-DILI incidence rate of 10.03% （140/1，396），comprising872 inthe traning set and 524 inthe testingset.Theresultsof the multivariate Logistic regressionanalysisrevealed thatolderage[OR =1.03 ， 95%CI （1.01，1.05）]，diabetes[OR =2.66 ， 95%CI （1.40， 5.07）]，smoking history [OR .=1.98 ， 95%CI （1.09，3.59）]，liver-related diseases [OR .=2.07 ， 95%CI （1.05，4.10）]， high aspartate aminotransferase （AsT） levels [OR .=1.03 ， 95%CI （1.02，1.05）]， high gamma-glutamyl transferase （GGT） levels ΔOR=1.18 。（剩余12720字）