摘要
目的:探讨血管瘤患儿治疗后复发的的影响因素,并构建列线图预测模型。方法:选取2021年5月至2023年5月于我院就诊的280例经普萘洛尔治疗的血管瘤患儿作为研究对象,根据治疗后是否复发分为复发组(71例)、未复发组(209例)。采用多因素Logistic回归分析探究血管瘤患儿治疗后复发的影响因素;采用R语言软件4.0“rms”包构建血管瘤患儿治疗后复发列线图预测模型,校正及决策曲线对列线图预测模型进行内部验证及临床预测效能评估。结果:多因素Logistic回归分析结果显示,血管瘤类型(OR=1.754,95%CI:1.102~3.565)、服药剂量(OR=1.774,95%CI:1.132~4.993)、治疗时间(OR=1.841,95%CI:1.142~5.845)、首次服药年龄(OR=1.695,95%CI:1.104~3.450)、停药时年龄(OR=1.889,95%CI:1.218~5.254)是血管瘤患儿治疗后复发的独立危险因素(P<0.05)。列线图预测模型的校正曲线与原始曲线及理想曲线接近,C-index为0.810(0.746~0.873),决策曲线显示列线图预测模型的阈值>0.17,临床净收益均高,且高于血管瘤类型、服药剂量、治疗时间、首次服药年龄、停药时年龄。结论:血管瘤患儿治疗后复发的影响因素为血管瘤类型、服药剂量、治疗时间、首次服药年龄、停药时年龄,以其作为预测因子构建的个性化列线图预测模型有助于血管瘤患儿治疗后复发放入预测评估,以期尽早干预、改善预后。
Objective:To investigate the influencing factors of post-treatment recurrence in children with hemangioma and construct a nomogram prediction model.Methods:A total of 280 children with hemangioma treated with propranolol in our hospital from May 2021 to May 2023 were enrolled and divided into the recurrence group(71 cases)and the non-recurrence group(209 cases)based on post-treatment outcomes.Multivariable logistic regression was performed to analyze the factors influencing the recurrence of hemangioma.R package 4.0‘rms’was used to construct a nomogram model for predicting the recurrence.Calibration and decision curves were used to internally validate the nomogram model and evaluate the clinical prediction effectiveness.Results:Multivariable logistic regression analysis showed that hemangioma type(OR=1.754,95%CI:1.102-3.565),medication dosage(OR=1.774,95%CI:1.132-4.993),treatment duration(OR=1.841,95%CI:1.142-5.845),age at initial medication(OR=1.695,95%CI:1.104-3.450),and age at treatment discontinuation(OR=1.889,95%CI:1.218-5.254)were independent risk factors of post-treatment recurrence of hemangioma among the children(P<0.05).The calibration curve of the nomogram model closely aligned with the original and ideal curves,with a C-index of 0.810(0.746-0.873).The decision curve showed that the threshold value of the nomogram model was>0.17,with high net clinical benefit for all of them,and was higher than the hemangioma type,medication dosage,treatment duration,age at initial medication,and age at treatment discontinuation.Conclusions:The factors affecting post-treatment recurrence in children with hemangiomas are hemangioma type,medication dosage,treatment duration,age at initial medication,and age at treatment discontinuation.A nomogram model constructed using these factors as predictors can help to predict and evaluate post-treatment recurrence in children with hemangiomas,enabling early intervention and improved prognosis.
作者
黄俊英
HUANG Junying(Department of Pediatric Surgery,Affiliated Hospital of Putian University,Putian 351100,China)
出处
《沈阳医学院学报》
2025年第3期282-287,共6页
Journal of Shenyang Medical College
关键词
血管瘤
普萘洛尔
影响因素
列线图预测模型
hemangioma
propranolol
influencing factors
nomogram prediction model
