基层医疗机构TAT皮试假阳性反应影响因素的Logistics回归分析及干预对策  

Logistic regression analysis and intervention countermeasures of factors related to false positive TAT skin test in primary medical institutions

作　　者：王玮琦[1] 张敏[1] 易瑜[1] 王颖[1] WANG Weiqi;ZHANG Min;YI Yu;WANG Ying(Panzhihua Central Hospital,Panzhihua Sichuan 617067,China)

机构地区：[1]攀枝花市中心医院,四川攀枝花617067

出　　处：《中国急救复苏与灾害医学杂志》2023年第2期236-239,243,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：四川省卫生和计划生育委员会科研课题(编号:2018CY-S-10)。

摘　　要：目的探讨基层医疗机构破伤风抗毒素(TAT)皮试假阳性反应有关影响因素的logistics回归分析及干预对策。方法选取2019年5月—2020年5月攀枝花市中心医院收治986例行TAT皮试患者作为研究对象,统计假阳性率,采用单、多因素方法分析基层医疗机构TAT皮试假阳性率独立危险因素,并建立Logistic回归方程预测模型,评估该模型预测假阳性发生特异性及敏感性。结果(1)986例行TAT皮试患者中,假阳性率为87.32%(861/986);(2)Logistic回归方程显示,年龄、TAT皮试液浓度、皮肤消毒剂是TAT皮试假阳性危险因素,饮酒距TAT皮试时间、TAT皮试部位、TAT皮试液配制方法、TAT皮试结果观察时间是TAT皮试假阳性保护因素(P<0.05);(3)Logistic回归模型评价模型建立具有统计学意义,Wald检验显示回归方程的系数差异有统计学意义,采用Hosmer-Lemeshow拟合优度检验显示模型拟合效果较好;(4)采用Logistic回归模型统计分析数据集,预测TAT皮试假阳性率的AUC为0.720,敏感度为80.84%,特异度为91.20%。结论基层医疗机构TAT皮试假阳性率主要与TAT皮试液浓度、配置方法、部位、结果观察时间有关,根据上述因素构建logistics回归预测模型对TAT皮试假阳性率预测价值高,利于临床学者确定合理防治措施,降低TAT皮试假阳性率。Objective To investigate the logistics regression analysis and intervention countermeasures of the influencing factors of the false positive skin test of tetanus antitoxin(TAT)in primary medical institutions.Methods 986 TAT skin test patients admitted to our hospital from May 2019 to May 2020 were selected as the research object,and the false positive rate was counted.Single and multi-factor methods were used to analyze the independent risk factors of TAT skin test false positive rate in primary medical institutions.And establish a logistic regression equation prediction model to evaluate the specificity and sensitivity of the model to predict the occurrence of false positives.Results(1)Among986 patients who underwent TAT skin test,the false positive rate was 87.32%(861/986);(2)Logistic regression equation showed that age,TAT skin test solution concentration,and skin disinfectant were false positives for TAT skin test Risk factors,drinking time from TAT skin test,TAT skin test site,TAT skin test solution preparation method,TAT skin test result observation time are the TAT skin test false positive protective factors(P<0.05);(3)Logistic regression model evaluation model The establishment is statistically significant.The Wald test shows that the coefficients of the regression equation are statistically significant.The Hosmer-Lemeshow goodness-of-fit test shows that the model fits better;(4)The logistic regression model is used to statistically analyze the data set and predict TAT The AUC of the false positive rate of the skin test was 0.720,the sensitivity was 80.84%,and the specificity was 91.20%.Conclusion The false positive rate of TAT skin test in primary medical institutions is mainly related to the concentration of TAT skin test solution,configuration method,location,and result observation time.The construction of a logistics regression prediction model based on the above factors has a high predictive value for the false positive rate of TAT skin test,which is beneficial to clinical scholars Determine reasonab

关 键 词：基层医疗机构 破伤风抗毒素 皮试 假阳性反应 影响因素 

分 类 号：R517.3[医药卫生—内科学]