轻度胃肠炎伴婴幼儿良性惊厥反复发作风险的列线图模型  

Nomogram model for the risk of recurrent episodes of benign infantile convulsions associated with mild gastroenteritis

作　　者：姚俊强[1] 张玲[1] YAO Junqiang;ZHANG Ling(Department of Pediatrics,Women and Children’s Hospital of Ningbo University,Ningbo 315012,China)

机构地区：[1]宁波大学附属妇女儿童医院儿内科,浙江宁波315012

出　　处：《新医学》2025年第1期53-59,共7页Journal of New Medicine

基　　金：浙江省医药卫生项目(2020KY883)。

摘　　要：目的探讨轻度胃肠炎伴婴幼儿良性惊厥(BICE)反复发作与肠道病毒、细胞因子之间的相关性,构建列线图预测模型,为早期识别BICE反复发作的高风险患儿提供参考。方法回顾性分析2021年12月至2023年12月于宁波大学附属妇女儿童医院神经内科住院部确诊的85例BICE患儿,根据惊厥发作次数将其分为观察组(≥2次)和对照组(1次),采用多因素Logistic回归分析探讨BICE反复发作与肠道病毒、细胞因子的相关性,构建预测模型,绘制列线图。采用受试者操作特征(ROC)曲线、校准曲线和决策曲线分析评估和验证模型。结果85例患儿中观察组60例,对照组25例,观察组患儿诺如病毒阳性率、IL-6和IL-10水平高于对照组,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示诺如病毒、IL-6和IL-10是BICE反复发作的独立危险因素(均P<0.05),基于这3个危险因素构建列线图模型。绘制ROC曲线进行模型评价,曲线下面积(AUC)为0.869(灵敏度75%、特异度84%),且校准曲线和决策曲线分析均表明该模型有良好的预测效能。结论诺如病毒、IL-6和IL-10与BICE反复发作具有相关性,据此构建的列线图模型具有良好的预测准确性,能快速评估BICE患儿反复发作的风险,从而尽早制定干预对策。Objective To analyze the correlation between recurrent episodes of benign infantile convulsions associated with mild gastroenteritis(BICE)and enterovirus and cytokines,and establish a nomogram prediction model,providing reference for early identification of children with high-risk recurrent episodes of BICE.Methods Eighty-five cases diagnosed with BICE in Department of Neurology,Women and Children’s Hospital of Ningbo University from December 2021 to December 2023 were retrospectively analyzed.According to the seizure frequency,they were divided into the observation group(≥2 times)and control group(1 time).Multivariate Logistic regression analysis was used to investigate the correlation between recurrent episodes of BICE and enterovirus and cytokines.A prediction model was constructed and a nomogram was drawn.The receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis were employed to analyze,evaluate and verify the prediction model.Results Among the 85 children,60 cases were included in the observation group and 25 were included in the control group.In the observation group,the positive rate of norovirus,IL-6 and IL-10 levels were higher than those in the control group,and the differences were statistically significant(all P<0.05).Multivariate Logistic regression analysis showed that norovirus,IL-6 and IL-10 levels were the independent risk factors for recurrent episodes of BICE(all P<0.05).A nomogram model was constructed based on these three risk factors.The ROC curve was drawn to evaluate the prediction model.The area under the ROC curve(AUC)was 0.869(75%for the sensitivity,84%for the specificity).Calibration curve and decision curve analysis demonstrated that the prediction model yielded high prediction efficiency.Conclusions Norovirus,IL-6 and IL-10 levels are associated with recurrent episodes of BICE.The nomogram model based on these three factors yields high prediction accuracy and high clinical application value and promptly assesses the risk of recurrent episodes o

关 键 词：轻度胃肠炎伴婴幼儿良性惊厥 婴幼儿 诺如病毒 列线图 细胞因子 

分 类 号：R72[医药卫生—儿科]