晚期早产儿发生呼吸衰竭的危险因素分析及预测模型的构建  

Risk factors analysis and predictive model construction for respiratory failure in late stage premature infants

作　　者：萧慧敏[1] 钟景良 梁健雁 陈玲 吴茜 XIAO Huimin;ZHONG Jingliang;LIANG Jianyan;CHEN Ling;WU Qian(Department of Neonatology,Houjie Hospital,Dongguan City,Dongguan,Guangdong 523000,China)

机构地区：[1]东莞市厚街医院新生儿科,广东东莞523000

出　　处：《临床肺科杂志》2024年第7期1002-1007,共6页Journal of Clinical Pulmonary Medicine

基　　金：东莞市社会发展科技项目(No.20221800903842)。

摘　　要：目的探讨晚期早产儿发生新生儿呼吸衰竭(NRF)的危险因素,并构建预测NRF发生的风险预测模型。方法将2019年12月-2022年12月本院收治的727例晚期早产儿纳入本次回顾性研究,根据是否发生呼吸衰竭分为NRF组(n=120)和非NRF组(n=607)。采用多因素Logistic回归分析筛选晚期早产儿NRF发生的独立危险因素,然后利用R语言构建列线图模型,然后对模型进行评估。结果本院晚期早产儿NRF发生率为16.51%(120/727);多因素Logistic回归分析显示,母亲文化程度低、母亲围产期感染、胎膜早破、妊娠高血压及5min Apgar评分低是晚期早产儿NRF发生的独立危险因素(P<0.05);列线图模型的ROC曲线下面积为0.861(95%CI:0.801~0.905),提示列线图模型的区分度良好;校准曲线结合Hosmer-Lemeshow检验显示预测模型的拟合度良好(χ^(2)=1.736,P=0.391)。结论母亲文化程度低、母亲围产期感染、胎膜早破、妊娠高血压及5min Apgar评分低与晚期早产儿NRF的发生独立相关,基于独立危险因素构建的列线图模型在预测晚期早产儿NRF的发生风险具有较高的预测效能和临床应用价值。Objective To investigate the risk factors for neonatal respiratory failure(NRF)in late-preterm infants and construct a risk prediction model for predicting the occurrence of NRF.Methods A retrospective study was conducted,including 727 late-preterm infants admitted to our hospital from December 2019 to December 2022.The infants were divided into the NRF group(n=120)and the non-NRF group(n=607)based on the occurrence of NRF.Multivariable logistic regression analysis was performed to identify independent risk factors for NRF in late-preterm infants.The nomogram model was developed using R language,and the model was evaluated.Results The incidence of NRF in late-preterm infants in our hospital was 16.51%(120/727).Multivariable logistic regression analysis showed that low maternal education level,maternal perinatal infection,premature rupture of membranes,hypertension during pregnancy,and low 5-minute Apgar scores were independent risk factors for NRF in late-preterm infants(P<0.05).The area under the ROC curve of the nomogram model was 0.861(95%CI:0.801~0.905),indicating good discrimination of the nomogram model.The calibration curve combined with the Hosmer-Lemeshow test showed a good model fit(χ^(2)=1.736,P=0.391).Conclusion Low maternal education level,maternal perinatal infection,premature rupture of membranes,hypertension during pregnancy,and low 5-minute Apgar score were independently associated with the occurrence of NRF in late preterm infants.The nomogram model constructed based on independent risk factors has a high predictive efficacy and clinical application value for predicting the risk of NRF in late preterm infants.

关 键 词：晚期早产儿 呼吸衰竭 危险因素 预测模型 

分 类 号：R722.6[医药卫生—儿科]