儿童难治性肺炎支原体肺炎早期预测模型的构建与验证

Construction and verification of early prediction model of mycoplasma pneumoniae in children with refractory pneumonia

目的探讨儿童难治性肺炎支原体肺炎(RMPP)早期预测模型的构建与验证。方法选取208例支原体肺炎(MPP)患儿作为研究对象。根据治疗1周后是否发生RMPP分为难治组和一般组。比较2组临床资料,用多因素Logistic回归分析与RMPP相关的因素,用R软件建立列线图预测模型并验证。结果2组性别、白细胞等临床资料对比差异无统计学意义(P>0.05)。但难治组年龄小于一般组(P<0.05),难治组呼吸困难数和伴肺不张数少于一般组(P<0.05),难治组降钙素原、C反应蛋白高于一般组(P<0.05)。多因素Logistic回归分析显示,年龄是发生RMPP的保护性因素,降钙素原和C反应蛋白是发生RMPP的独立危险因素。将相关因素纳入列线图,预测RMPP发生的C-index为0.893。结论年龄、降钙素原等因素构建的列线图可用于早期预测儿童RMPP。

Objective To establish and verify the early prediction model of mycoplasma pneumoniae pneumonia(RMPP)in children.Methods A total of 208 children with mycoplasma pneumonia(MPP)were studied.The RMPP of children occurred one week after treatment was divided into refractory group and normal group.The clinical data of the two groups were compared.Multivariate Logistic regression was used to analyze the factors related to RMPP,and R software was used to establish and verify the nomogram prediction model.Results There was no difference in gender,white blood cell and other clinical data between the two groups(P>0.05);However,the age of the refractory group was lower than that of the general group(P<0.05),and the number of dyspnea and atelectasis in the refractory group was lower than that of the general group(P<0.05),and procalcitonin and C-reactive protein in the refractory group were higher than those in the general group(P<0.05).Multiple Logistic regression analysis showed that age was a protective factor for RMPP in children,and procalcitonin and C-reactive protein were independent risk factors for RMPP.When relevant factors were included in the nomogram,the c-index for predicting the occurrence of RMPP was 0.893.Conclusion The nomogram constructed by age,procalcitonin and other factors can be used to predict children RMPP in the early stage.