摘要
目的:建立识别新生儿院内真菌感染高危人群的风险评分方法,为预防性使用抗真菌药物提供依据。方法:通过回顾性调查及Logistic回归分析,筛查出新生儿发生院内真菌感染的独立危险因素,建立风险预测模型及评分方法,并利用受试者工作特征曲线(receiver operating characteristic curve,ROC)评估效能。结果:新生儿发生院内真菌感染的独立危险因素为极早产儿(孕龄<32周)、极低出生体重(<1 500 g)、细菌性败血症、使用广谱抗生素>5天、深静脉留置导管、气管插管,模型组和检验组中评分越高的新生儿发生院内真菌感染的几率越大,并且低、高得分组真菌感染发生率具有统计学差异(P<0.001),模型组和检验组ROC曲线下面积分别为0.868和0.859。结论:该风险预测模型能够帮助临床医生较准确地筛查出可能发生院内真菌感染的高危新生儿,指导预防性抗真菌药物使用。
Objective： To establish a risk scoring method for identifying high risk neonates of nosocomial fungal infection,provide a basis for application of prophylactic antifungal drugs.Methods： A retrospective investigation and logistic regression analysis were used to screen independent risk factors of neonatal nosocomial fungal infection,a risk predictive model and scoring method were established,receiver operating characteristic curve（ROC） was used to evaluate the efficiency of scoring method.Results： The independent risk factors of neonatal nosocomial fungal infection included very premature infants（ 32 gestational weeks）,very low birth weight（ 1 500 g）,bacterial septicemia,broad-spectrum antibiotics therapy 5 days,central venous catheterization and tracheal intubation.The higher the scores were,the higher the incidence rates of neonatal nosocomial fungal infection in model group and check-up group were;there was statistically significant difference in the incidence rate of neonatal nosocomial fungal infection between high score group and low score group（P 0.001）,the areas under ROC curve in model group and check-up group were 0.868 and 0.859,respectively.Conclusion： The risk predictive model can help clinicians to screen out high risk neonates of nosocomial fungal infection exactly and direct application of prophylactic antifungal drugs.
出处
《中国妇幼保健》
CAS
北大核心
2013年第22期3602-3604,共3页
Maternal and Child Health Care of China
基金
湖北省自然科学基金项目〔2011CDB540〕
