儿童腺病毒肺炎后BO发生的影响因素分析及预测模型构建  

Analysis of influencing factors and construction of a predictive model for bronchiolitis obliterans after adenovirus pneumonia in children

作　　者：赵红霞 唐丽敏[1] 高杰 马佳丽 李春辉 韩晓慧 王丽静 唐永在 Zhao Hongxia;Tang Limin;Gao Jie;Ma Jiali;Li Chunhui;Han Xiaohui;Wang Lijing;Tang Yongzai(Department of Pediatrics,Tangshan Maternal and Child Health Hospital,Tangshan Hebei 063000,China;Department of Pediatrics,North China University of Science and Technology Affiliated Hospital,Tangshan Hebei 063000,China)

机构地区：[1]河北省唐山市妇幼保健院儿内科,河北唐山063000 [2]华北理工大学附属医院儿科,河北唐山063000

出　　处：《保健医学研究与实践》2024年第11期73-78,共6页Health Medicine Research and Practice

基　　金：河北省医学科学研究课题计划项目(20242147)。

摘　　要：目的探讨影响儿童腺病毒肺炎后闭塞性细支气管炎(BO)发生的危险因素,并构建风险预测模型。方法选择2019年1月—2024年1月唐山市妇幼保健院收治并接受随访的腺病毒肺炎患儿120例为研究对象。随访半年,根据随访结果明确120例患儿是否发生BO,发生BO的患儿归于BO组,未发生BO的患儿归于非BO组。分析120例腺病毒肺炎患儿BO发生情况,采用多因素逐步回归分析儿童腺病毒肺炎后BO发生的危险因素,并根据筛选出的危险因素构建风险预测模型,通过受试者工作特征(ROC)曲线对所构建预测模型的预测效果进行评估。结果120例腺病毒肺炎患儿中,有31.67%(38/120)的患儿发生BO;住院时间≥12.5 d、降钙素原(PCT)≥0.47 ng/m L、乳酸脱氢酶(LDH)≥717.28 U/L、机械通气持续时间≥6.5 d是儿童腺病毒肺炎后BO发生的危险因素(P<0.05);儿童腺病毒肺炎后BO发生的预测模型预测BO的曲线下面积(AUC)为0.909(95%CI:0.860~0.959),敏感度为97.40%,特异度为75.60%。结论住院时间、PCT水平、LDH水平、机械通气持续时间是儿童腺病毒肺炎后BO发生的危险因素,据此所构建的风险预测模型对于儿童腺病毒肺炎后BO的发生具有一定的预测价值,值得临床应用。Objective To explore the risk factors influencing the occurrence of bronchiolitis obliterans(BO)after adenovirus pneumonia in children and establish a risk prediction model.Methods A total of 120 children with adenovirus pneumonia admitted to and followed up at Tangshan Maternal and Child Health Hospital from January 2019 to January 2024 were se-lected as the study participants.The children were followed up for six months,and based on the follow-up results,the 120 children were allocated to a BO group and a non-BO group.The occurrence of BO was analyzed in the 120 children with ade-novirus pneumonia.Multivariate stepwise regression analysis was used to identify the risk factors for BO after adenovirus pneumonia in children,and a risk prediction model was constructed based on the identified risk factors.The predictive per-formance of the constructed model was assessed using the receiver operating characteristic(ROC)curve.Results Among the 120 children with adenovirus pneumonia,31.67%(38/120)developed BO.Length of hospital stay≥12.5 days,procal-citonin(PCT)≥0.47 ng/mL,lactate dehydrogenase(LDH)≥717.28 U/L,and duration of mechanical ventilation≥6.5 days were identified as risk factors for BO after adenovirus pneumonia in children(P<0.05).The predictive model for BO after adenovirus pneumonia in children had an AUC of 0.909(95%CI:0.860-0.959),with a sensitivity of 97.40%and specificity of 75.60%.Conclusion Length of hospital stay,PCT levels,LDH levels,and duration of mechanical ventilation are risk factors for BO after adenovirus pneumonia in children.The constructed risk prediction model has certain predictive value for the occurrence of BO after adenovirus pneumonia in children and holds promise for application in clinical practice.

关 键 词：腺病毒肺炎患儿 闭塞性细支气管炎 危险因素 预测模型 

分 类 号：R725.6[医药卫生—儿科]