慢性荨麻疹患儿经西替利嗪联合地氯雷他定治疗后预后的列线图模型构建  

Construction of a column chart model for prognosis of children with chronic urticaria treated with cetirizine combined with desloratadine

作　　者：谭茜 王燕 黄冬男 TAN Qian;WANG Yan;HUANG Dongnan(Hainan Women and Children's Medical Center,Haikou 570100,China)

机构地区：[1]海南省妇女儿童医学中心,海口570100

出　　处：《中国免疫学杂志》2025年第4期943-947,953,共6页Chinese Journal of Immunology

基　　金：海南省自然科学基金面上项目(818MS170);海南省临床医学中心建设项目(琼卫医函[2021]75号)。

摘　　要：目的:探讨慢性荨麻疹儿童经西替利嗪及地氯雷他定联合用药后预后的影响因素,并构建列线图预测模型。方法:选取2019年1月至2021年12月在海南省妇女儿童医学中心进行西替利嗪联合地氯雷他定治疗的182例慢性荨麻疹患儿为研究对象,进行为期1年的随访,根据预后情况分为复发组(n=51)与未复发组(n=131)。对比两组患儿的病历资料,采用独立样本t检验及χ^(2)检验分析影响慢性荨麻疹儿童经西替利嗪及地氯雷他定联合用药后复发的相关指标;MedCalc软件对差异具有统计学意义的计量指标进行ROC曲线分析,探讨其对慢性荨麻疹儿童经西替利嗪及地氯雷他定联合用药后复发的预测价值;logistic回归分析探究影响慢性荨麻疹儿童经西替利嗪及地氯雷他定联合用药后复发的独立危险因素;R语言软件4.0“rms”包构建慢性荨麻疹儿童经西替利嗪及地氯雷他定联合用药后复发的列线图预测模型,校正曲线及决策曲线对列线图预测模型进行内部验证及临床预测效能评估。结果:两组患儿在病程、既往过敏性疾病史、发作频率、风团数量、风团持续时间、风团平均直径、IgE、IFN-γ、IL-10、IL-18、CRP方面的差异均有统计学意义(P<0.05)。病程、发作频率、风团数量、风团持续时间、风团平均直径、IgE、IFN-γ、IL-10、IL-18、CRP的AUC分别为0.854、0.697、0.739、0.876、0.847、0.767、0.902、0.804、0.829、0.850,最佳截断值分别为8个月、4次/周、6个、3 h、2.1 cm、149.7 U/ml、27.2 ng/L、3.6 ng/L、40.5 ng/L、2.6 mg/L。病程、IgE、IFN-γ、IL-10、IL-18、CRP是影响慢性荨麻疹儿童经西替利嗪及地氯雷他定联合用药后复发的独立危险因素。列线图预测模型的校正曲线与原始曲线及理想曲线接近,C-index为0.625(95%CI:0.613~0.702),模型拟合度高;列线图预测模型的阈值>0.16,可提供临床净收益,且临床净收益均高于病程、IgE、IFN-γ�Objective:To explore the influencing factors of prognosis in children with chronic urticaria treated with cetirizine and desloratadine in combination,and to construct a column chart prediction model.Methods:A total of 182 children with chronic urticaria who underwent cetirizine combined with desloratadine treatment in Hainan Women and Children's Medical Center from January 2019 to December 2021 were selected as study subjects for a one-year follow-up.They were divided into a relapse group(n=51)and a non relapse group(n=131)based on prognosis.Compared the medical records of two groups of children,and conducted independent sample t-test andχ^(2) to analyze the relevant indicators that affect the recurrence of chronic urticaria in children treated with cetirizine and desloratadine in combination;using MedCalc software,ROC curve analysis was conducted on statistically significant econometric indicators to explore their predictive value for recurrence in children with chronic urticaria treated with cetirizine and desloratadine in combination;independent risk factors for recurrence in children with chronic urticaria after combined use of cetirizine and desloratadine were analyzed by logistic regression analysis;R language software 4.0"rms"package was used to construct a column chart prediction model for the recurrence of chronic urticaria in children after the combination of cetirizine and desloratadine.Column chart prediction model was internally validated and evaluated for clinical predictive efficacy through calibration curve and decision curve.Results:Differences between the two groups of children were statistically significant(P<0.05)in terms of disease duration,history of previous allergic diseases,frequency of attacks,number of wind clusters,duration of wind clusters,mean diameter of wind clusters,IgE,IFN-γ,IL-10,IL-18 and CRP.AUCs for disease duration,episode frequency,number of wind clusters,duration of wind clusters,mean diameter of wind clusters,IgE,IFN-γ,IL-10,IL-18 and CRP were 0.854,0.697,0.739,0.876,0

关 键 词：慢性荨麻疹 西替利嗪 地氯雷他定 预后 列线图预测模型 

分 类 号：R758.24[医药卫生—皮肤病学与性病学]