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 ›› 2020, Vol. 12 ›› Issue (6): 506-.

• 临床研究 • 上一篇    下一篇

多因素综合毛细支气管炎后发生反复喘息的预测模型构建

童志杰,黄建军,吴佩琼   

  1. 510000 广州,广州市妇女儿童医疗中心呼吸科
  • 出版日期:2020-12-25 发布日期:2021-05-14
  • 通讯作者: 童志杰,E-mail:tongqiyu2002@163.com
  • 作者简介:童志杰(1972-),男,副主任医师。研究方向:儿童呼吸系统疾病的诊治

Establishment of prediction model of recurrent wheezing after multifactor bronchiolitis

TONG Zhijie,HUANG Jianjun,WU Peiqiong.   

  1. Respiratory Department of Guangzhou Women and Children′s Medical Center,Guangzhou 510000,China
  • Online:2020-12-25 Published:2021-05-14

摘要: 目的:探讨多因素综合毛细支气管炎后发生反复喘息的预测模型的构建。
方法:选取我院2016年5月至2019年2月收治的毛细支气管炎患儿91例,均在治疗出院后随访1年。根据患儿随访后发生喘息情况分为反复喘息患儿41例和非喘息患儿50例。收集患儿一般临床资料,采用Logistic回归构建毛细支气管炎患儿发生反复喘息的联合检测因子模型,并绘制受试者工作特征曲线(ROC)。
结果:反复喘息患儿烟草接触史、肺纹理增粗、湿疹、牛奶蛋白阳性、未补充维生素A、D占比高于非喘息患儿,差异有统计学意义(P<0.05);经Logistic回归分析发现,烟草接触史(OR=10.145,95% CI=1.541~20.728)、未补充维生素A、D(OR=5.652,95%CI=1.541~20.728)、湿疹(OR=1.370,95%CI=1.089~1.723)、牛奶蛋白(OR=1.711,95%CI=1.079~2.712)是影响毛细支气管炎患儿发生反复喘息的独立危险因素;得出联合检测因子模型表达式为:Logit(P)=-4.751+2.317X1+1.732X2+0.315X3+0.537X4;联合检测因子模型最佳临界值为0.457,灵敏度为89.47%,特异度为86.79%,曲线下面积为0.852(0.651~0.977)。
结论:多因素综合构建毛细支气管炎患儿联合检测因子模型能较好的预测患儿发生反复喘息。

关键词: 毛细支气管炎, 反复喘息, 多因素分析, 儿童

Abstract: Objective:To explore the establishment of a predictive model for recurrent wheezing after multifactor bronchiolitis.
Methods:Totally 91 patients with multifactor bronchiolitis admitted to our hospital from May 2016 to February 2019 were selected.All the patients were followed up for one year after discharge.The patients were divided into two groups based on occurrence of wheezing after follow-up:repeated wheezing group(n=41) and nonwheezing group(n=50).General clinical data of the two groups were collected.Logistic regression was used to construct a combined detection factor model of repeated wheezing in children with bronchiolitis.The receiver operating characteristic curve(ROC) was drawn.
Results:The proportion of tobacco contact history,lung texture thickening,eczema milk protein positive and no supplementation of vitamin A and D in the repeated wheezing group was higher than that in the non-wheezing group(P<0.05).Logistic regression analysis showed that tobacco contact history(OR=10.145,95%CI=1.541~20.728),supplementation of vitamin A and D(OR=5.652,95%CI=1.541~20.728),eczema (OR=1.370,95%CI=1.089~1.723),and milk protein(OR=1.711,95%CI=1.079~2.712) were independent risk factors for recurrent wheezing in children with bronchiolitis.The expression of joint detection factor model was:Logit(P)=-4.751+2.317X1+1.732X2+0.315X3+0.537X4.The best critical value of the combined detection factor model was 0.457,the sensitivity was 89.47%,the specificity was 86.79%,and the area under the curve was 0.852(0.651~0.977).
Conclusion:Multifactor comprehensive construction combined detection factor model for children with bronchiolitis can better predict the occurrence of repeated wheezing.

Key words: Bronchiolitis, Repeated wheezing, Multivariate analysis, Children