间质性肺炎患者糖皮质激素治疗后继发真菌感染的风险预测模型构建及其应用价值  

Construction and Application Value of Risk Prediction Model for Secondary FungalInfection in Patients with Interstitial Pneumonia After Glucocorticoid Therapy

作　　者：左园园 张梦丽 ZUO Yuanyuan;ZHANG Mengli(Department of Pharmacy,the Third People’s Hospital of Henan Province,Zhengzhou 450000,China)

机构地区：[1]河南省直第三人民医院药学部,河南郑州450000

出　　处：《河南医学研究》2024年第7期1203-1206,共4页Henan Medical Research

摘　　要：目的分析间质性肺炎患者糖皮质激素治疗后继发真菌感染的危险因素,建立风险预测模型。方法回顾性分析2019年1月至2023年5月河南省直第三人民医院收治的行糖皮质激素治疗的102例间质性肺炎患者的临床资料,根据有无继发真菌感染分为感染组(32例)和未感染组(70例),比较两组临床资料,采用logistic多因素回归分析影响间质性肺炎患者糖皮质激素治疗后继发真菌感染的危险因素,建立继发真菌感染的风险预测模型,并绘制受试者工作特征(ROC)曲线评估模型预测效果。结果单因素分析显示,两组血清白蛋白、侵入操作、合并糖尿病比较,差异有统计学意义(P<0.05);logistic多因素回归分析显示,血清白蛋白≤30 g·L^(-1)、侵入操作、合并糖尿病是影响间质性肺炎患者继发真菌感染独立危险因素(P<0.05);以血清白蛋白、侵入操作、合并糖尿病建立模型,预测间质性肺炎患者继发真菌感染敏感度为63.54%,特异度为91.27%,曲线下面积为0.841。结论血清白蛋白≤30 g·L^(-1)、侵入操作、合并糖尿病为影响间质性肺炎患者糖皮质激素治疗后继发真菌感染独立危险因素,以上述因素为基础构建的预测模型对真菌感染预测效能较佳,可为临床预防及控制真菌感染提供客观依据。Objective To analyze the risk factors of secondary fungal infection in patients with interstitial pneumonia after glucocorticoid therapy and establish a risk prediction model.Methods The clinical data of 102 patients with interstitial pneumonia who received glucocorticoid therapy in the Third People’s Hospital of Henan Province from January 2019 to May 2023 were analyzed retrospectively.According to the presence or absence of secondary fungal infection,the patients were divided into infected group(32 cases)and uninfected group(70 cases).The clinical data of the two groups were compared,multivariate logistic regression was used to analyze the risk factors of secondary fungal infection in patients with interstitial pneumonia after glucocorticoid treatment,the risk prediction model of secondary fungal infection was established,and the receiver operating characteristic(ROC)curve was plotted to evaluate the prediction effect of the model.Results Univariate analysis showed that there were significant differences in serum albumin,invasive procedure and diabetes mellitus between the two groups(P<0.05).Logistic multivariate regression analysis showed that serum albumin≤30 g·L^(-1),invasive operation and diabetes mellitus were independent risk factors for secondary fungal infection in patients with interstitial pneumonia(P<0.05).The sensitivity,specificity of serum albumin,invasive operation and diabetes mellitus in predicting secondary fungal infection in patients with interstitial pneumonia were 63.54%,91.27%,and the area under the curve was 0.841.Conclusion Serum albumin level≤30 g·L^(-1),invasive procedures and diabetes are independent risk factors for secondary fungal infection in patients with interstitial pneumonia after glucocorticoid therapy.The prediction model based on the above factors is more effective in predicting fungal infection,thereby providing an objective basis for clinical prevention and control of fungal infection.

关 键 词：间质性肺炎 糖皮质激素 继发 真菌感染 风险预测 

分 类 号：R563.13[医药卫生—呼吸系统]