婴幼儿支气管肺炎发生反复喘息的危险因素分析及列线图预测模型的构建  

Risk Factor Analysis of Recurrent Wheezing in Infants with Bronchopneumonia and Construction of Nomogram Prediction Model

作　　者：刘明凤 LIU Mingfeng(Pingxiang Maternal and Child Health Hospital,Pingxiang 337000 Jiangxi,China)

机构地区：[1]萍乡市妇幼保健医院,江西萍乡337000

出　　处：《现代诊断与治疗》2023年第5期636-640,共5页Modern Diagnosis and Treatment

基　　金：江西省卫生健康委科技计划项目(202311755)。

摘　　要：目的 分析婴幼儿支气管肺炎发生反复喘息的危险因素,并构建Nomogram预测模型。方法 选取2020年1月至2022年10月我院收治的急支气管肺炎患儿170例,将其根据是否发生反复喘息分为观察组55例和对照组115例,观察组患儿支气管肺炎引起反复喘息发作,对照组患儿支气管肺炎未引起反复哮喘发作。分析影响婴幼儿支气管肺炎发生反复喘息的危险因素;并采用内部数据验证Nomogram模型临床效能。结果 观察组患儿出生体重和支气管肺炎发作频次均高于对照组,处于吸烟环境中、生活在城市中、早产、孕期使用抗生素、母体吸烟较多,差异有统计学意义(P<0.05);出生体重、支气管肺炎发作频次的AUC为0.706、0.768,最佳截断值为10 kg、3次;出生体重(>10 kg)、支气管肺炎发作频次(>3次/年)、吸烟环境(是)、生活地区(城市)、早产(是)、孕期使用抗生素(是)、孕期母体吸烟(是)是影响支气管肺炎患儿引起反复哮喘发作危险因素(P<0.05);模型预测患儿反复喘息的风险C-index为0.745(95%CI:0.674~0.831);模型预测支气管肺炎患儿引起反复哮喘发作的风险阈值>0.07。结论 出生体重高、支气管肺炎发作频次高、经常处于吸烟环境中、生活在城市、早产、孕期使用和吸烟均为响支气管肺炎患儿引起反复哮喘发作危险因素,且基于变量构建的模型有较好的预测能力。Objectives To analyze the risk factors of recurrent wheezing in infants with bronchopneumonia and to construct a Nomogram prediction model.Methods A total of 170 children with acute bronchopneumonia admitted to our hospital from January 2020 to October 2022 were selected and divided into observation group(n=55)and control group(n=115)according to whether recurrent wheezing occurred.The observation group had recurrent wheezing attacks caused by bronchopneumonia,while the control group had no recurrent wheezing attacks caused by bronchopneumonia.This study analyzes the risk factors of recurrent wheezing in infants with bronchopneumonia,and the internal data were used to verify the clinical efficacy of Nomogram model.Results The birth weight and incidence of bronchopneumonia in the observation group were significantly higher than those in the control group,especially for those in a smoking environment,living in cities,with premature delivery,using antibiotics during pregnancy,and with frequent maternal smoking(P<0.05).The AUC of birth weight and frequency of bronchopneumonia were 0.706 and 0.768,and the best cut-off value was 10kg and 3 times.Birth weight(>10 kg),frequency of bronchopneumonia attack(>3 times/year),smoking environment(yes),living area(city),premature delivery(yes),use of antibiotics during pregnancy(yes),maternal smoking(yes)were risk factors for recurrent asthma attack in children with bronchopneumonia(P<0.05).The model predicted that the risk of repeated wheezing in children was 0.745(95%CI:0.674~0.831).The risk threshold of recurrent asthma attack in children with bronchopneumonia predicted by the model exceeds 0.07.Conclusions High birth weight,high frequency of bronchopneumonia, frequent smoking, living in cities, premature delivery,use of antibiotics during pregnancy and smoking are all risk factors for recurrent asthma attacks in children with bronchopneumonia, and the model based on these variables has a good predictive power.

关 键 词：支气管肺炎 喘息 危险因素 模型 

分 类 号：R725.6[医药卫生—儿科]