基于临床多参数构建重症肺炎支原体肺炎患儿的风险预警模型  

Constructing A Risk Warning Model for Severe Mycoplasma Pneumoniae Pneumonia Children Based on Clinical Multi Parameters

作　　者：莫婉婷 高平明 万瑞平[2] 冼慧文 林丹霞 MO Wan-ting;GAO Ping-ming;WAN Rui-ping;XIAN Hui-wer;LIN Dan-xia(The Second Clinical School of Southern Medical University,Guangzhou,Guangdong,510515,China;Department of Pediatrics,Foshan Women and Children Hospital,Foshan,Guangdong,528000,China)

机构地区：[1]南方医科大学第二临床医学院,广东广州510515 [2]佛山市妇幼保健院儿科,广东佛山528000

出　　处：《现代生物医学进展》2025年第3期511-518,共8页Progress in Modern Biomedicine

基　　金：广东省基础与应用基础研究基金联合基金项目(2020A1515110095)。

摘　　要：目的:基于临床资料、实验室指标和及影像学指标构建重症肺炎支原体肺炎(SMPP)患儿风险预警模型。方法:选择佛山市妇幼保健院2021年1月至2023年12月收治的肺炎支原体肺炎(MPP)患儿162例,其中SMPP患儿64例作为重症组,其余98例患儿纳入轻症组。收集患儿的一般资料、实验室指标及影像学指标等。应用单因素和多因素Logistic回归模型分析SMPP发生的的影响因素,基于多因素Logistic回归模型分析影响因素构建SMPP患儿发生风险的预警模型。应用受试者工作特征(ROC)曲线分析风险预警模型对SMPP发生的预测价值。结果:重症组3岁≤年龄<6岁比例、病程、体温、热程、C反应蛋白(CRP)、血沉(ESR)、乳酸脱氢酶(LDH)、口唇发绀比例、三凹征阳性比例、胸腔积液比例、病变部位为下叶比例、心电图异常表现比例、肺外表现比例显著高于轻症组(P<0.05),两组性别、白细胞计数(WBC)、中性粒细胞比例、降钙素原(PCT)比较无统计学差异(P>0.05)。多因素Logistic回归分析模型,结果显示,3岁≤年龄<6岁、体温偏高、热程较长、CRP升高、ESR升高、LDH升高、口唇发绀、三凹征阳性、存在胸腔积液、病变部位为下叶、存在心电图异常表现、存在肺外表现是SMPP发生的危险因素(P<0.05)。ROC曲线分析显示,风险预警模型的曲线下面积(AUC)为0.829,敏感度为84.82%,特异度为78.15%,该风险预警模型的实际预测曲线与预测曲线吻合较好,决策曲线显示,模型阈值概率范围为4.61%~88.14%。结论:基于一般资料、实验室指标及影像学指标等临床多参数构建的风险预警模型对SMPP发生具有一定的预测价值。Objective:To construct a risk warning model for severe mycoplasma pneumoniae pneumonia(SMPP)children based on clinical data,laboratory indicators and imaging indicators.Methods:162 Mycoplasma pneumoniae pneumonia(MPP)children who were admitted in Foshan Women and Children Hospital from January 2021 to December 2023 were selected,64 SMPP children were included in severe group,the remaining 98 children were included in mild group.The general data,laboratory indicators and imaging indicators of the children were collected.The influencing factors for the occurrence of SMPP were analyzed by univariate and multivariate logistic regression models,and a risk warning model for the occurrence of SMPP children was constructed based on multivariate logistic regression model.The predictive value of the risk warning model for the occurrence of SMPP were analyzed by receiver operating characteristic(ROC)curve.Results:The proportion of 3 years old≤age<6 years old,course of disease,body temperature,fever course,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),lactate dehydrogenase(LDH),cyanosis of lips,positive triconcave sign,pleural effusion,lesion site was the lower lobe,abnormal electrocardiogram and extrapulmonary manifestations in severe group were significantly higher than those in mild group(P<0.05),there were no significant differences in gender,white blood cell count(WBC),neutrophil ratio and procalcitonin(PCT)between the two groups(P>0.05).Multivariate logistic regression analysis model showed that,3 years old≤age<6 years old,high body temperature,long fever course,CRP elevated,ESR elevated,LDH elevated,cyanosis of lips,positive triconcave sign,pleural effusion,lesion site was the lower lobe,abnormal electrocardiogram and extrapulmonary manifestations were risk factors for the occurrence of SMPP(P<0.05).ROC curve analysis showed that,the area under the curve(AUC)of the risk warning model was 0.829,the sensitivity was 84.82%,and the specificity was 78.15%,the actual prediction curve of the risk warning mo

关 键 词：重症 肺炎支原体肺炎 一般资料 实验室指标 影像学指标 预警模型 

分 类 号：R3[医药卫生—基础医学] R725.6