新生儿低血糖风险预测模型的构建及效果验证  

Construction of neonatal hypoglycemia risk prediction model and its effect verification

作　　者：刘颖[1] 朱珠[1] 单春剑[1] 蒲丛珊 王义婷 丁磊[1] LIU Ying;ZHU Zhu;SHAN Chunjian;PU Congshan;WANG Yiting;DING Lei(Women's Hospital of Nanjing Medical University,Nanjing 210004,China)

机构地区：[1]南京医科大学附属妇产医院/南京市妇幼保健院,江苏省南京市210004

出　　处：《护理实践与研究》2024年第1期29-36,共8页Nursing Practice and Research

基　　金：江苏省妇幼保健协会科研课题(编号:FYX202108)。

摘　　要：目的构建新生儿发生低血糖临床风险因素及构建预测模型,为早期识别新生儿低血糖提供理论参考。方法选取2020年1月—2022年1月南京市某医院1330例新生儿为研究对象,按7:3分为建模组(n=931)、验证组(n=399)。利用Logistic回归构建模型,Hosmer-Lemeshow、ROC等评价拟合优度、预测效果。结果新生儿低血糖发生率在建模组与验证组中分别为12.57%(117/931)、12.78%(44/399),二者之间比较差异无统计学意义(P>0.05)。母亲合并糖尿病、母亲肥胖、孕期及哺乳期服用β受体阻滞剂药物、产前使用皮质类固醇类药物、小于胎龄、血糖检测方式6个因素是独立影响因素。建模组模型ROC曲线下面积0.893(95%CI:0.855~0.931,P=0.000),H-L检验结果为P=0.155,验证组曲线下面积占比0.847(95%CI:0.828~0.9876,P=0.000),H-L检验结果P=0.401。结论本模型预测效果良好,可有效预测新生儿低血糖并划分层级,为新生儿低血糖的临床护理提供理论依据。Objective To provide theoretical reference for early identification of neonatal hypoglycemia by constructing clinical risk factors for neonatal hypoglycemia and building a prediction model.Methods A total of 1330 newborns in a hospital in Nanjing from January 2020 to January 2022 were selected as the research subjects,and divided into a modeling group(n=931)and a validation group(n=399)according to 7:3.Logistic regression was used to build the model,and Hosmer-Lemeshow and ROC were used to evaluate the goodness of fit and prediction effect.Results The incidence of neonatal hypoglycemia in the modeling group and validation group were 12.57%(117/931)and 12.78%(44/399)respectively,there was no statistically significant difference between the two groups(P>0.05).Six factors,including maternal diabetes,maternal obesity,use of beta-blockers during pregnancy and lactation,prenatal use of corticosteroids,small for gestational age,and blood glucose testing methods were the independent influencing factors.The area under the ROC curve of the modeling group was 0.893(95%CI:0.855~0.931,P=0.000),and the H-L test result was P=0.155.The area under the curve of the validation group was 0.847(95%CI:0.828~0.9876,P=0.000),and the H-L test result was P=0.401.Conclusion:This model had good prediction effect and can effectively predict and classify neonatal hypoglycemia,providing a theoretical basis for clinical care of neonatal hypoglycemia.

关 键 词：新生儿低血糖 影响因素 预测模型 风险分层 母亲合并糖尿病 

分 类 号：R473.72[医药卫生—护理学]