摘要
目的观察血清粒细胞集落刺激因子(G-CSF)、白介素-10(IL-10)、单核细胞趋化蛋白-1(MCP-1)对早产儿支气管肺发育不良(BPD)的预测价值,并建立列线图风险模型,为早产儿BPD的预防提供参考。方法选取2018年12月一2023年2月2家医院收治的早产儿288例,将发生BPD的早产儿纳入BPD组,未发生BPD的早产儿纳入无BPD组。比较无BPD组、BPD组血清G-CSF、IL-10、MCP-1水平及一般资料;经多因素逐步logistic回归分析法分析早产儿BPD的影响因素;建立早产儿发生BPD的列线图风险模型;采用内部数据验证列线图风险模型效能;采用决策曲线评估列线图风险模型的临床净收益。结果288例早产儿中,15例出生28d后仍需氧疗,16例胎龄<32周且矫正至胎龄36周时仍需要机械通气或氧疗,将其纳入BPD组,其余257例纳入无BPD组。与无BPD组比较,BPD组血清G-CSF、MCP-1水平升高,IL-10水平降低(P<0.05)。与无BPD组比较,BPD组出生孕周<28周、出生体质量<1.5kg、动脉导管未闭百分率升高(P<0.05)。多因素逐步logistic回归分析显示,动脉导管未闭、G-CSF、MCP-1是早产儿BPD的危险因素,出生孕周、出生体质量、IL-10是其保护因素(P<0.05)。内部验证结果显示,列线图风险模型的一致性指数(C-index)为0.811(95%CI:0.754~0.868)。根据患者数据行决策曲线分析,结果显示当列线图风险模型预测早产儿BPD的风险阈值>0.06时提供了附加临床收益。结论基于血清G-CSF、IL-10、MCP-1构建预测早产儿BPD的列线图风险模型具有较好的效能,可提高预测早产儿BPD发生风险的准确性。
Objective This paper aims to observe the predictive value of serum granulocyte colony stimulating factor(G-CSF),interleukin-10(IL-10),monocyte chemoattractant protein-1(MCP-1)for bronchopulmonary dysplasia(BPD)in preterm infants,and to establish a nomogram risk model to provide reference for the prevention of BPD in preterm infants.Methods A total of 288 preterm infants admitted to two hospitals from December 2018 to February 2023 were selected,and those with BPD were included in the BPD group,while those without BPD were included in the non-BPD group.The serum levels of G-CSF,IL-1O,MCP-1 and general data were compared between the non-BPD group and the BPD group.The influencing factors of BPD in preterm infants were analyzed by multivariate stepwise logistic regression method.A nomogram risk model for BPD in preterm infants was established.The efficacy of the nomogram risk model was validated by internal data.The clinical net benefit of the nomogram risk model was evaluated by decision curve.Results Among 288 preterm infants,15 still needed oxygen therapy after birth at 28 d,and 16 had a gestational age<32 weeks and still needed mechanical ventilation or oxygen therapy when corrected to gestational age 36 weeks,who were included in the BPD group,while the remaining 257 were included in the non-BPD group.Compared with the non-BPD group,serum G-CSF and MCP-1 levels were increased while IL-10 levels were decreased in the BPD group(P<0.05).Compared with the non-BPD group,gestational age<28 weeks,birth weight<1.5 kg,patent ductus arteriosus percentage were increased in the BPD group(P<0.05).Multivariate stepwise logistic regression analysis showed that patent ductus arteriosus,G-CSF and MCP-1 were risk factors for BPD in pre-term infants,while gestational age,birth weight and IL-10 were protective factors(P<0.05).Internal validation results showed that the consistency index(C-index)of nomogram risk model was 0.811(95%CI:0.754-0.868).Decision curve analysis based on patient data showed that when nomogram risk model pre
作者
陈丽萍
戚利那
CHEN Li-ping;QI Li-na(Department of Pediatrics,Linping District Maternal and Child Health Care Hospital(Linping Branch of Affiliated Obstetrics and Gynecology Hospital of Zhejiang University Medical School),Hangzhou,Zhejiang 311100,China;不详)
出处
《中国卫生检验杂志》
CAS
2023年第23期2900-2904,2908,共6页
Chinese Journal of Health Laboratory Technology
