布鲁氏菌病膝关节受累的肌骨超声预测模型构建与评估

doi:10.19871/j.cnki.xfcrbzz.2026.04.005

新发传染病电子杂志 ›› 2026, Vol. 11 ›› Issue (4): 30-35.doi: 10.19871/j.cnki.xfcrbzz.2026.04.005

布鲁氏菌病膝关节受累的肌骨超声预测模型构建与评估

祁秀¹, 麻凌峰², 栗平³

1.呼和浩特市第二医院超声科,内蒙古呼和浩特 010020;
2.南方医科大学第八附属医院/佛山市顺德区第一人民医院超声科,广东佛山 528308;
3.内蒙古医科大学第二附属医院超声科,内蒙古呼和浩特 010030

收稿日期:2026-05-28 出版日期:2026-08-31 发布日期:2026-09-14
通讯作者: 栗平,Email：liping5767@sina.com
基金资助:
内蒙古自治区自然科学基金项目（2023LHMS08053）

Development and evaluation of a musculoskeletal ultrasound-based prediction model for knee joint involvement in brucellosis

Qi Xiu¹, Ma Lingfeng², Li Ping³

1. Department of Ultrasound, Hohhot Second Hospital,Hohhot 010020, China;
2. Department of Ultrasound, The Eighth Affiliated Hospital of Southern Medical University, The First People's Hospital of Shunde, Guangdong Foshan 528308, China;
3. Department of Ultrasound, The Second Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Hohhot 010030, China

Received:2026-05-28 Online:2026-08-31 Published:2026-09-14

摘要/Abstract

摘要： 目的基于肌骨超声探讨布鲁氏菌病患者膝关节受累的高危因素,构建并验证膝关节受累的预测模型,为临床早期筛查、风险分层及个体化干预提供理论支撑。方法纳入2023年10月至2025年10月于呼和浩特市第二医院就诊的布鲁氏菌病患者132例,其中膝关节受累60例。收集一般资料和肌骨超声图像,通过χ²检验、Logistic回归分析筛选出独立危险因素,构建预测模型,采用Bootstrap法内部验证,并通过受试者工作特征（receiver operating characteristic curve,ROC）曲线、Hosmer-Lemeshow检验、校准曲线、决策曲线分析（decision curve,analysis,DCA）、沙普利加性解释（shapley additive explanations,SHAP）和列线图评估解释模型的准确性和临床实用性。结果髌下脂肪垫血流信号和关节腔/髌上囊积液是独立危险因素（均P<0.05）。模型区分良好,校准度较高,DCA显示阈值概率0.07~0.65时临床净收益良好。SHAP示髌下脂肪垫血流信号贡献最大,关节腔/髌上囊积液次之,两者均正向增加风险。列线图可视化模型,预测概率为64.89%。结论髌下脂肪垫血流信号和关节腔/髌上囊积液为布鲁氏菌病患者膝关节受累的独立危险因素。该预测模型对膝关节受累风险具有预测能力。

关键词: 肌骨超声, 布鲁氏菌病, 膝关节受累, 沙普利加性解释

Abstract: Objective To explore the high risk factors of knee joint involvement in patients with brucellosis based on musculoskeletal ultrasound, to construct and verify the prediction model of knee joint involvement, and to provide theoretical support for early clinical screening, risk stratification and individualized intervention. Method A total of 132 patients with brucellosis who were admitted to the Second Hospital of Hohhot from October 2023 to October 2025 were enrolled, including 60 patients with knee joint involvement. General data and musculoskeletal ultrasound images were collected. Independent risk factors were screened by χ² test and Logistic regression analysis, and a prediction model was constructed. Bootstrap method was used for internal verification. The accuracy and clinical practicability of the prediction model were evaluated by receiver operating characteristic curve (ROC), Hosmer-Lemeshow test, calibration curve, decision curve analysis (DCA), Shapley Additive Explanations (SHAP) and nomogram. Result Blood flow signal of infrapatellar fat pad and joint cavity / suprapatellar bursa effusion were independent risk factors (all P<0.05). The model was well distinguished and the calibration degree was high. The clinical net income was good when the threshold probability of DCA was 0.07-0.65. SHAP showed that the blood flow signal of infrapatellar fat pad contributed the most, followed by joint cavity / suprapatellar bursa effusion, both of which positively increased the risk. The prediction probability of the nomogram visualization model is 64.89%. Conclusion Blood flow signal of infrapatellar fat pad and joint cavity / suprapatellar bursa effusion is an independent risk factor for knee joint involvement in patients with brucellosis. The prediction model has the ability to predict the risk of knee joint involvement.

Key words: musculoskeletal ultrasound, Brucellosis, Knee joint involvement, Shapley additive explanations

中图分类号:

祁秀, 麻凌峰, 栗平. 布鲁氏菌病膝关节受累的肌骨超声预测模型构建与评估[J]. 新发传染病电子杂志, 2026, 11(4): 30-35.

Qi Xiu, Ma Lingfeng, Li Ping. Development and evaluation of a musculoskeletal ultrasound-based prediction model for knee joint involvement in brucellosis[J]. Electronic Journal of Emerging Infectious Diseases, 2026, 11(4): 30-35.

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布鲁氏菌病膝关节受累的肌骨超声预测模型构建与评估

Development and evaluation of a musculoskeletal ultrasound-based prediction model for knee joint involvement in brucellosis

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