摘要
目的构建个体化预测肺炎支原体感染患儿合并肺外心血管系统损伤的风险Nomogram模型。方法选取2020年1月—2022年12月宣城市中心医院收治的肺炎支原体感染患儿作为研究对象,收集患儿的临床资料,根据是否合并肺外心血管系统损伤将患者分为心血管系统损伤组(损伤组)(n=51)和无心血管系统损伤组(未损伤组)(n=137)。使用单因素和多因素Logistic回归分析肺炎支原体感染患儿合并肺外心血管系统损伤的危险因素,并建立相关Nomogram预测模型。结果2组发热时间、最高体温、中性粒细胞百分比、C反应蛋白水平和7 d内使用大环内酯类药物史比较,差异有统计学意义(P均<0.05)。多因素Logistic回归分析显示,发热时间≥7 d、最高体温较高、中性粒细胞百分比≥70%和C反应蛋白≥35 mg/L是肺炎支原体感染患儿合并肺外心血管系统损伤的独立危险因素,7 d内使用大环内酯类药物是其保护因素。Nomogram模型验证结果:一致性指数为0.822(95%CI:0.791~0.853),Hosmer-Lemeshoe拟合优度检验显示模型拟合较好,接受者操作特征曲线曲线的曲线下面积为0.817(95%CI:0.787~0.847),在0.5%~98.0%的列线图可预测范围内,模型净获益。结论肺炎支原体感染患儿合并肺外心血管系统损伤的危险因素包括发热时间≥7 d、最高体温较高、中性粒细胞百分比≥70%和C反应蛋白≥35 mg/L,保护因素为7 d内使用大环内酯类药物。基于上述因素构建的Nomogram模型对肺炎支原体感染患儿肺外心血管系统损伤的发生风险具有较高的预测价值。
Objective To construct an individualized Nomogram model for predicting the risk of extra-pulmonary cardiovascular system injury in children with Mycoplasma pneumoniae infection.Methods We retrospectively analyzed clinical data from children with Mycoplasma pneumoniae infection admitted to our hospital from January 2020 to December 2022.The children were divided into injury groups(n=51)and non-injury groups(n=137)based on the presence of extra-pulmonary cardiovascular system injury.The risk factors for extra-pulmonary cardiovascular system injury in children with Mycoplasma pneumoniae infection were analyzed using univariate and multifactorial logistic regression,and a related nomogram prediction model was established.Results The differences in fever duration,maximum body temperature,neutrophil percentage,C-reactive protein and use of macrolide antibacterial drugs within 7 d were statistically significant(P<0.05)when comparing the 2 groups.Multifactorial logistic regression analysis showed that duration of fever≥7 d,higher maximum body temperature,neutrophil percentage≥70%and C-reactive protein≥35 mg/L were independent risk factors for extra-pulmonary cardiovascular system injury in children with Mycoplasma pneumoniae infection,and the use of macrolide antimicrobials within 7 d was a protective factor.Nomogram model validation results:the C-index was 0.822(95%CI:0.791-0.853),the Hosmer-Lemeshoe goodness-of-fit test showed a good model fit,the AUC of the ROC curve was 0.817(95%CI:0.787-0.847),a net benefit of the model within the predictable range of 0.5%to 98.0%of the column line graph.Conclusions Risk factors for combined extrapulmonary cardiovascular system injury in children with Mycoplasma pneumoniae infection include fever duration≥7 d,higher maximum body temperature,neutrophil percentage≥70%and C-reactive protein≥35 mg/L,and protective factors are the use of macrolide antibacterial drugs within 7 d.The Nomogram model constructed based on the above factors has high predictive value for the risk of
作者
葛敬芳
高飞
章浩宇
樊晨
GE Jingfang;GAO Fei;ZHANG Haoyu;FAN Chen(Department of Pediatrics,Xuancheng Central Hospital,242000,China)
出处
《传染病信息》
2024年第2期158-163,共6页
Infectious Disease Information
关键词
肺炎支原体感染
肺外心血管系统损伤
危险因素
列线图
Mycoplasma pneumoniae infection
extrapulmonary cardiovascular system injury
risk factors
nomogram
