Age and mean platelet volume-based nomogram for predicting the therapeutic efficacy of metoprolol in Chinese pediatric patients with vasovagal syncope  

作　　者：Xiao-Juan Du Ya-Qian Huang Xue-Ying Li Ying Liao Hong-Fang Jin Jun-Bao Du 

机构地区：[1]Department of Pediatrics,Peking University First Hospital,No.1 Xi’anmen Street,West District,Beijing,100034,China [2]State Key Laboratory of Vascular Homeostasis and Remodeling,Peking University,No.38,Xueyuan Road,Haidian District,Beijing,100191,China [3]Department of Statistics,Peking University First Hospital,Beijing,100034,China

出　　处：《World Journal of Pediatrics》2024年第9期957-965,共9页世界儿科杂志（英文版）

基　　金：supported by National High-Level Hospital Clinical Research Funding(Multi-center Clinical Research Project of Peking University First Hospital,2022CR59);Clinical Medicine Plus X-Young Scholars Project(PKU2022LCXQ028);the Fundamental Research Funds for the Central Universities,China.

摘　　要：Background Vasovagal syncope(VVS)is the most common type of orthostatic intolerance in children.We investigated whether platelet-related factors related to treatment efficacy in children suffering from VVS treated with metoprolol.Methods Metoprolol-treated VVS patients were recruited.The median duration of therapy was three months.Patients were followed and divided into two groups,treament-effective group and treatment-ineffective group.Logistic and least absolute shrinkage selection operator regressions were used to examine treatment outcome variables.Receiver-operating characteristic(ROC)curves,precision-recall(PR)curves,calibration plots,and decision curve analyses were used to evaluate the nomogram model.Results Among the 72 patients who complete the follow-up,treatment-effective group and treatment-ineffective group included 42(58.3%)and 30(41.7%)cases,respectively.The patients in the treatment-effective group exhibited higher mean platelet volume(MPV)[(11.0±1.0)fl vs.(9.8±1.0)fl,P<0.01]and platelet distribution width[12.7%(12.3%,14.3%)vs.11.3%(10.2%,12.2%),P<0.01]than those in the treatment-ineffective group.The sex ratio was significantly different(P=0.046).A fit model comprising age[odds ratio(OR)=0.766,95%confidence interval(CI)=0.594-0.987]and MPV(OR=5.613,95%CI=2.297-13.711)might predict therapeutic efficacy.The area under the curve of the ROC and PR curves was computed to be 0.85 and 0.9,respectively.The P value of the Hosmer-Lemeshow test was 0.27.The decision curve analysis confirmed that managing children with VVS based on the predictive model led to a net advantage ranging from 0.01 to 0.58.The nomogram is convenient for clinical applications.Conclusion A novel nomogram based on age and MPV can predict the therapeutic benefits of metoprolol in children with VVS.

关 键 词：METOPROLOL NOMOGRAM Retrospective study Therapeutic effect Vasovagal syncope 

分 类 号：R725.4[医药卫生—儿科]