摘要
目的探讨肺炎支原体肺炎患儿伴气道黏液栓形成的独立影响因素,利用数据构建列线图模型并实施验证。方法选择2022年1月至2023年12月期间在徐州市儿童医院就诊治疗的肺炎支原体肺炎患儿253例作为研究对象。依据患儿在纤维支气管镜检查中是否出现黏液栓实施分组,描述肺炎支原体肺炎患儿合并出现气道黏液栓的比例情况,肺炎支原体肺炎患儿合并出现气道黏液栓的单因素以及多因素分析,肺炎支原体肺炎患儿合并出现气道黏液栓的预测模型构建和预测效能分析。结果在调查的253名肺炎支原体肺炎患儿中,共有133名患儿在纤维支气管镜检查中发现存在气道黏液栓,比例为52.57%。从单因素分析的结果可见,出现气道黏液栓患儿的年龄较大,发热时间长度较长,发生胸腔积液的比例更高,血液检查结果中的C反应蛋白以及乳酸脱氢酶的水平更高,以上指标同未出现气道黏液栓的患儿比较,差异均有统计学意义(P<0.05)。多因素分析结果可见,年龄较大、发热时间长度较长、血液检查结果中的C反应蛋白以及乳酸脱氢酶水平较高的患儿合并出现气道黏液栓的风险更大(P<0.05)。以多因素分析的结果创建列线图模型,一致性指数(C-index)为0.742。利用Bootstrap自抽样法进行列线图模型的内部验证,完成1000次自助抽样后获取校准曲线,平均误差数值为0.020。使用年龄、发热时间长度、C反应蛋白、乳酸脱氢酶的数值以及Logistic回归方程的P值对患儿出现黏液栓的情况实施受试者操作特征(ROC)曲线的预测计算,曲线下面积分别为0.690、0.666、0.687、0.815、0.885。结论年龄较大、体温异常升高时间较长、伴随C反应蛋白和乳酸脱氢酶指标上升的肺炎支原体肺炎儿童,可能存在气道黏液栓形成的潜在风险。
【Objective】To investigate the independent factors affecting the formation of airway mucus plugs in children with Mycoplasma pneumoniae pneumonia,and to construct a nomogram model with the data for verification.【Methods】A total of 253 children with Mycoplasma pneumoniae pneumonia who were treated in Xuzhou Children's Hospital from January 2022 to December 2023 were selected as the study objects.Children were grouped according to the presence or absence of mucous plugs during bronchoscopy.The proportion of children with Mycoplasma pneumoniae pneumonia complicated with airway mucus plugs was described.Univariate and multivariate analysis of airway mucus plugs in children with Mycoplasma pneumoniae pneumonia were conducted.A predictive model was constructed and predictive efficacy was analyzed for airway mucus plugs in children with Mycoplasma pneumoniae pneumonia.【Results】Among the 253 children with Mycoplasma pneumoniae pneumonia in this survey,133 children were found to have airway mucus plugs in bronchoscopy,accounting for 52.57%.As can be seen from the results of single factor analysis,the children with airway mucus plug were older,the duration of fever was longer,the proportion of pleural effusion was higher,and the levels of C-reactive protein and lactate dehydrogenase in blood test results were higher.Compared with the children without airway mucus plug,the data differences were statistically significant(P<0.05).The results of multivariate analysis showed that older children,longer duration of fever,and higher levels of C-reactive protein and lactate dehydrogenase in blood tests were more at risk of developing airway mucus plugs(P<0.05).A nomogram model was created based on the results of multi-factor analysis,and the C-index was 0.742.Bootstrap self-sampling method was used for internal verification of the nomogram model,and the calibration curve was obtained after 1,000 self-sampling,with an average error value of 0.020.Age,length of fever,values of C-reactive protein,lactate dehydrogenase and P-value of logistic regression equation were used to predict and calculate the reciever operating characteristic(ROC)curve for the occurrence of mucus plugs in children,and the areas under the curve were 0.690,0.666,0.687,0.815 and 0.885,respectively.【Conclusion】Children with Mycoplasma pneumoniae pneumonia who are older,have a longer period of abnormally elevated body temperature,and have elevated levels of C-reactive protein and lactate dehydrogenase may have a potential risk of airway mucus plug formation.
作者
卞芳芳
吴月娥
BIAN Fangfang;WU Yue'e(Respiratory Medicine Department 1,Xuzhou Children's Hospital,Xuzhou,Jiangsu 221000,China)
出处
《中国医学工程》
2025年第4期31-36,共6页
China Medical Engineering
关键词
肺炎支原体
气道黏液栓
社区性肺炎
呼吸道功能
支气管
Mycoplasma pneumoniae
airway mucus plug
community pneumonia
respiratory function
bronchus
