摘要
目的构建手足口病合并早期神经系统受累的临床预测规则(CPR)。方法收集2014-01~2017-02郑州市儿童医院感染科诊治的手足口病患儿1 132例,使用R 3.4.4软件进行所有数据的分析处理,筛选相应预测变量构建CPR,并使用ROC曲线和校准曲线对其性能进行评价。结果所有纳入患儿根据是否合并中枢神经系统(CNS)受累分为轻症组695例和CNS损害组437例。最终构建的CPR包括4个独立危险因素:体温≥38.5℃,发热时间≥3 d,白细胞≥10.8×10~9/L,年龄<1岁(或2~3岁)。诊断性ROC曲线下面积为0.821,敏感度为89.2%,特异度为80.7%,最佳临界值为4分。结论构建的CPR具有简单、实用和直观等优势,对后续研究及临床实践具有一定的参考价值。
Objective To construct a clinical prediction rule（CPR） for hand-foot-mouth disease（HFMD） complicated with early neurological involvement. Methods The clinical data of 1 132 children with HFMD diagnosed were collected in the Children′s Hospital Affiliated to Zhengzhou University from January 2014 to February 2017. R Software Version 3.4.4 was used to analyze the data and the corresponding predictive variables were screened to construct a CPR for HFMD. ROC curve and calibration curve were used to evaluate the performance of the CPR. Results All the included cases were divided into mild group（n=695） and central nervous system（CNS） lesion group（n=437） depending on whether they had neurological involvement or not. The final constructed CPR included four independent risk factors： peak temperature ≥38.5 ℃, fever duration ≥3 days, WBC≥10.8×109/L, age〈1 year（or 2 to 3 years old）. The area under the diagnostic ROC curve was 0.821, with a sensitivity of 89.2%, a specificity of 80.7% and a cutoff value of 4 points. Conclusion The CPR constructed in this study has the advantages of being simple, practical and intuitive, and has a certain reference value for follow-up research and clinical practice.
作者
黄平
冯慧芬
王芳
秦新华
赵保玲
王斌
赵敬
HUANG Ping;FENG Hui-fen;WANG Fang(Department of Gastroenterology,the Fifth Affiliated Hospital of Zhengzhou University,Henan 450052,Chin)
出处
《中国临床新医学》
2018年第8期768-772,共5页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金
国家自然科学基金资助项目(编号:81473030)
河南省医学科技攻关计划项目(编号:201403130)
河南省卫生系统出国研修项目(编号:2015065)
关键词
重症手足口病
神经系统受累
临床预测规则
Severe hand foot mouth disease （HFMD）
Neurological involvement
Clinical predictionrule（CPR）
