ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2025, Vol. 17 ›› Issue (2): 178-183.doi: 10.20274/j.cnki.issn.1674-3865.2025.02.017

• • 上一篇    

先天性心脏病患儿术后发生肺部感染的危险因素及预测模型构建

周赛君, 宋青青, 杨美玉   

  1. 410007 长沙,中南大学湘雅医学院附属儿童医院(湖南省儿童医院)心血管内科
  • 收稿日期:2024-10-17 出版日期:2025-04-25 上线日期:2025-04-25
  • 通讯作者: 宋青青,E-mail:164618062@qq.com
  • 基金资助:
    湖南省卫生健康委科研计划项目(202106012338)

Risk factors and prediction model construction of postoperative pulmonary infection in children with congenital heart disease

ZHOU Saijun,SONG Qingqing,YANG Meiyu   

  1. Xiangya Hospital,Central South University(Hunan Children′s Hospital),Changsha 410007,China

  • Received:2024-10-17 Published:2025-04-25 Online:2025-04-25
  • Contact: SONG Qingqing,E-mail:164618062@qq.com

摘要: 目的:了解先天性心脏病患儿术后发生肺部感染相关危险因素,并构建风险预测模型。方法:回顾性分析2023年5月至2024年5月湖南省儿童医院收治的256例先天性心脏病患儿相关临床资料,根据是否发生肺部感染将其分为肺部感染组29例和未发生肺部感染组227例。采用Logistic回归分析患儿术后发生肺部感染的危险因素,并构建列线图预测模型。绘制受试者工作特征曲线(ROC)分析预测模型对先天性心脏病患儿术后发生肺部感染的预测价值。结果:256例先天性心脏病患儿肺部感染率为11.33%(29/256),多因素Logistic分析结果显示,年龄<3岁、心功能分级≥Ⅲ级、体外循环时间>100 min、复杂型先天性心脏病、手术时间>150 min为患儿术后发生肺部感染的独立危险因素(P<0.05)。校准曲线显示构建的列线图模型有较好的一致性,C index指数为0.832[95%CI(0.816 0.859)],ROC曲线下面积为0.882[95%CI(0.835,0.898)],说明本研究列线图模型具有良好的校准度和区分度。结论:根据先天性心脏病患儿术后发生肺部感染的相关独立危险因素构建的列线图预测模型,有助于临床筛选术后肺部感染高风险患儿,减少术后肺部感染发生率,有一定的临床应用价值。


关键词: 先天性心脏病, 肺部感染, 危险因素, 预测模型, 列线图

Abstract: Objective:To learn about the risk factors for postoperative pulmonary infection in children with congenital heart disease and to construct a risk prediction model.Methods:A retrospective analysis was conducted on the clinical data of 256 children with congenital heart disease,who received treatment in Hunan Children′s Hospital between May 2023 and May 2024.Based on whether pulmonary infection occurred,the children were divided into pulmonary infection group(29 cases) and no infection group(227 cases).Logistic regression was used to analyze the risk factors for postoperative pulmonary infection,and a nomogram prediction model was constructed.The receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of the model for postoperative pulmonary infection in these children.Results:Among the 256 children with congenital heart disease,29 developed pulmonary infection,with an infection rate of 11.33%(29/256).Multivariate Logistic regression analysis showed that age <3 years,heart function grade≥ Ⅲ,extracorporeal circulation time >100 minutes,complex congenital heart disease,and surgical time > 150 minutes were independent risk factors for postoperative pulmonary infection(all P<0.05).The calibration curve indicated that the constructed nomogram model had good consistency,with a C index of 0.832[95%CI(0.816,0.859)] and an area under the ROC curve(AUC) of 0.882[95%CI(0.835,0.898)],suggesting that the nomogram model had good calibration and discrimination.Conclusion:The nomogram prediction model,which is constructed based on independent risk factors for postoperative pulmonary infection in children with congenital heart disease,is helpful to identify the children with high risk of postoperative pulmonary infection and reduce the incidence of postoperative pulmonary infection.It has certain clinical application value.

Key words: Congenital heart disease, Pulmonary infection, Risk factors, Prediction model, Nomogram