| 罗季,陈永刚,马雅妮,等.儿童耐多药结核病发生的相关影响因素及其预测模型的建立[J].安徽医药,2024,28(3):592-596. |
| 儿童耐多药结核病发生的相关影响因素及其预测模型的建立 |
| Establishment of related influencing factors and prediction model of multidrug-resistant tuberculosis in children |
| |
| DOI：10.3969/j.issn.1009-6469.2024.03.037 |
| 中文关键词: 广泛耐药结核 儿童 影响因素 列线图 预测模型 |
| 英文关键词: Extensively drug-resistant tuberculosis Children Influencing factors Nomograph Predictive model |
| 基金项目:昆明市卫健委卫生科研课题项目( 2020-13-01-001)；云南省孔令义专家工作站项目( 2019IC047) |
|
| 摘要点击次数: 828 |
| 全文下载次数: 386 |
| 中文摘要: |
| 目的探究儿童耐多药结核病( MDR-TB)发生的相关影响因素及其预测模型的建立。方法回顾性选取 2010年 3月 1日至 2022年 2月 28日昆明市第三人民医院结核病病儿，统计 MDR-TB发生情况，比较 MDR-TB病儿与非 MDR-TB病儿临床资料，通过 logistic多因素回归模型分析儿童 MDR-TB发生的相关影响因素，采用 R语言构建儿童 MDR-TB发生的列线图预测模型，并进行一致性检验。结果共纳入 850例结核病病儿，其中初治 MDR-TB病儿占 5.65%，复治 MDR-TB病儿占 24.88%，总 MDR-TB病儿占 10.47%；logistic多因素回归模型分析显示，年龄、吸烟史、治疗情况、感染播散性、与结核病病人接触、合并人类免疫缺陷病毒( HIV)感染、合并乙型肝炎病毒( HBV)感染是儿童 MDR-TB发生的独立危险因素，规范用药是独立保护因素( P<0.05)；根据影响因素构建儿童 MDR-TB发生的列线图预测模型，通过 Bootstrap自抽样法验证显示该预测模型预测值与实际观测值基本一致，一致性指数( C-index)为 0.960，具有良好的区分度；预测模型 ROC曲线的曲线下面积( AUC)为 0.96［95%CI:(0.94，0.98)］，预测效能较高。结论病儿年龄、吸烟史、治疗情况、感染播散性、与结核病病人接触、合并 HIV感染、合并 HBV感染等均为 MDR-TB发生的影响因素，根据影响因素构建的列线图预测模型可较好预测结核病病儿发生 MDR-TB的风险。 |
| 英文摘要: |
| Objective To explore the related influencing factors of multidrug-resistant tuberculosis (MDR-TB) in children and the es. tablishment of a predictive model.Methods Children with tuberculosis in Kunming Third People's Hospital from March 1, 2010 toFebruary 28, 2022 were retrospectively selected, the incidence of MDR-TB was counted, and the clinical data of children with MDR-TB and those without MDR-TB were compared, the relevant influencing factors of the occurrence of MDR-TB in children by logistic multifactorial regression model were analyzed, a column-line graph prediction model of the occurrence of MDR-TB in children was con. structed by using the R language, and the consistency test was performed.Results A total of 850 children with tuberculosis were in. cluded in this study, of which 5.65% were initially treated with MDR-TB, 24.88% were retreated with MDR-TB, and 10.47% were in to. tal MDR-TB. Logistic multivariate regression model analysis showed that age, smoking history, treatment status, dissemination of infec.tion, contact with tuberculosis patients, HIV infection, and hepatitis B virus (HBV) infection were independent risk factors for the occur.rence of MDR-TB in children, and standardized medication was an independent protective factor (P<0.05); According to the influenc. ing factors, a nomogram prediction model for the occurrence of MDR-TB in children was constructed. The Bootstrap self-sampling meth.od showed that the prediction value of the prediction model was basically consistent with the actual observation value, and the C-index was 0.960, which had a good degree of discrimination; the prediction model ROC The area under the curve (AUC) of the curve was 0.96[95%CI:(0.94,0.98)], indicating high predictive power.Conclusions Children's age, smoking history, treatment, infection spread, con.tact with tuberculosis patients, combined HIV infection, combined HBV infection, etc. are all influencing factors of MDR-TB. The no. mogram prediction model based on the influencing factors can better predict the risk of MDR-TB in children with tuberculosis. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
