目的 建立脑卒中后神经源性膀胱(post-stroke neurogenic bladder,PSNB)患者尿路感染风险动态列线图模型，为临床筛查提供工具。方法 2023年6月至2025年6月，采用便利抽样法选取某院收治的360例PSNB患者为研究对象。根据其是否发生尿路感染分为感染组(n=94)和对照组(n=266)，分析其危险因素并建立动态列线图预测模型。结果 360例PSNB患者尿路感染发生率为26.11%；感染组与对照组患者在年龄、低蛋白血症、NIHSS评分、留置尿管时间等项目上的差异均有统计学意义(均P<0.05)；年龄(OR=3.065)、性别(OR=3.467)、糖尿病(OR=2.750)、NIHSS评分(OR=1.192)、留置尿管时间(OR=1.777)、膀胱功能训练介入时间(OR=1.490)是PSNB患者尿路感染的影响因素(均P<0.05)。绘制PSNB患者尿路感染风险的列线图模型的受试者工作特征曲线下面积为0.929；经Hosmer-Lemeshow检验，模型拟合情况良好；校准曲线与决策曲线显示模型具有较好的校准度和临床有效性。结论 构建的PSNB患者尿路感染风险动态列线图模型具有良好的预测效能，值得推广。

Objective To establish a dynamic nomogram model for predicting the risk of urinary tract infection (UTI) in patients with post-stroke neurogenic bladder (PSNB), so as to provide a clinical screening tool.Methods A total of 360 PSNB patients admitted to a hospital from June 2023 to June 2025 were enrolled by the convenience sampling method.They were divided into infection group (n=94) and control group (n=266) according to the occurrence of UTI.The risk factors were analyzed, and a dynamic nomogram prediction model was constructed.Results The incidence of UTI in 360 PSNB patients was 26.11%.There were significant differences in age, hypoalbuminemia, NIHSS score, indwelling catheter duration and other indicators between the infection group and the control group (all P<0.05).Age (OR=3.065), gender (OR=3.467), diabetes mellitus (OR=2.750), NIHSS score (OR=1.192), indwelling catheter duration (OR=1.777), and intervention timing of bladder function training (OR=1.490) were influencing factors for UTI in PSNB patients (P<0.05).The area under the receiver operating characteristic curve (AUC) of the nomogram model was 0.929.The Hosmer-Lemeshow test showed good model fit .Calibration curve and decision curve analysis demonstrated favorable calibration and clinical effectiveness of the model.Conclusions The established dynamic nomogram model for predicting UTI risk in PSNB patients shows good predictive performance and is worthy of clinical promotion.

R473.74

武汉中西医结合骨科医院(武汉体育学院附属医院)科研项目(WTFY202312)