| 章燕.基于Logistic方程分析小儿腺病毒肺炎病情加重的危险因素及预测模型构建[J].安徽医药,待发表. |
| 基于Logistic方程分析小儿腺病毒肺炎病情加重的危险因素及预测模型构建 |
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| 投稿时间：2025-02-08 录用日期：2025-05-07 |
| DOI： |
| 中文关键词: 腺病毒 肺炎 儿童 病情加重 预测模型 |
| 英文关键词: |
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| 中文摘要: |
| 目的:采用Logistic方程小儿腺病毒肺炎(AP)病情加重的相关因素,并构建预测模型。方法:选取铜陵市人民医院2023年6月~2024年6月123例AP患儿,根据其病情严重程度分为普通腺病毒肺炎(GAP)组(n=103)、重症腺病毒肺炎(SAP)组(n=20),分析所有患儿基线资料,使用Logistic多因素分析小儿AP病情加重的危险因素,并结合多因素分析结果构建风险预测模型。结果:经比对,SAP组患儿住院天数(9.61±1.97)d、咳嗽天数(13.47±2.88)d、发热天数(4.24±1.65)d、存在营养不良比例(25.00%)、Murray肺损伤评分(2.26±0.54)分、血清LDH(826.98±211.41)U/L、sB7-H3(8.39±2.32)μg/L、sTREM-1(65.24±15.38)pg/mL均高于GAP组住院天数(6.92±1.03)d、咳嗽天数(6.35±3.50)d、发热天数(2.03±1.10)d、存在营养不良比例(4.85%)、Murray肺损伤评分(1.49±0.25)分、血清LDH(345.71±87.64)U/L、sB7-H3(6.84±1.87)μg/L、sTREM-1(59.51±10.94)pg/mL(P<0.05)；Logistic多因素回归分析显示,是否存在营养不良(OR=30.579,β=3.420)、Murray肺损伤评分(OR=55.221,β=4.011)、LDH(OR=1.008,β=0.008)、sB7-H3(OR=1.573,β=0.453)、sTREM-1(OR=1.114,β=0.108)是小儿AP病情加重的影响因素(P<0.05)；构建列线图模型:Log(P)=3.420×是否存在营养不良+4.011×Murray肺损伤评分+0.008×LDH+0.453×sB7-H3+0.108×sTREM-17.371,其ROC曲线下的AUC为0.921＞0.7,灵敏度和特异度分别为89.80%和91.30%。Hosmer-Lemeshow结果:x2=16.882,P=0.318＞0.05,说明模型诊断效能较高且具有一定的校准能力。结论:AP患儿营养不良、Murray肺损伤评分、血清LDH、sB7-H3、sTREM-1水平可作为预测疾病加重的指标,通过上述因素构建的预测模型也具备良好的预测能力,可为临床治疗提供参考。 |
| 英文摘要: |
| Objective:Logistic equation was used to determine the factors related to the exacerbation of adenovirus pneumonia (AP) in children, and a prediction model was established.Method:A total of 123 children with AP were selected from Tongling People"s Hospital from June 2023 to June 2024.According to the severity of their disease, they were divided into GAP group (n=103) and SAP group (n=20).Baseline data of all children were analyzed,Multivariate Logistic analysis was used to analyze the risk factors of worsening AP disease in children, and the risk prediction model was built based on the results of multivariate analysis.Result:By comparison, In SAP group, the hospitalization days were (9.61±1.97) d, the cough days were (13.47±2.88) d, the fever days were (4.24±1.65) d, the proportion of malnutrition was (25.00%), Murray lung injury score was (2.26±0.54), and the serum LDH was (826.98±211.41) U /L, sB7-H3 (8.39±2.32) μg/L, sTREM-1 (65.24±15.38) pg/mL were higher than those of GAP group in hospital days (6.92±1.03) d, cough days (6.35±3.50) d, fever days (2.03±1.10) d, and the proportion of malnutrition (4.8) 5%), Murray lung injury score (1.49±0.25), serum LDH (345.71±87.64) U/L, sB7-H3 (6.84±1.87) μg/L, sTREM-1 (59.51±10.94) pg/mL (P<0.05);Logistic multivariate regression analysis showed whether there was malnutrition (OR=30.579, β=3.420), Murray lung injury score (OR=55.221, β=4.011), LDH (OR=1.008, β=0.008), sB7-H3 (OR=1.573, β=0.453) and sTREM-1 (OR=1.114, β=0.108) were the factors affecting the severity of AP in children (P<0.05);Build a nomogram model: Log (P) =3.420× whether malnutrition exists +4.011×Murray lung injury score +0.008×LDH+0.453×sB7-H3+0.108×sTREM-17.371, and the AUC under the ROC curve was 0.921 > 0.7. The sensitivity and specificity were 89.80% and 91.30% respectively. Hosmer-Lemeshow results: x2=16.882, P=0.318 > 0.05, indicating that the model has high diagnostic efficiency and certain calibration ability.Conclusion:Malnutrition, Murray lung injury score, serum LDH, sB7-H3 and sTREM-1 levels in AP children can be used as indicators to predict disease exacerbation, and the prediction model constructed by the above factors also has good prediction ability, which can provide reference for clinical treatment. |
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