目的 探讨12岁以内儿童塑型性支气管炎复发风险影响因素并构建临床预测模型,旨在为早期识别复发高危患儿及后续诊治工作提供更多参考。方法 回顾性纳入2016年1月—2024年1月于我院诊治12岁以内儿童塑型性支气管炎患儿共111例,根据发病后随访8周以上是否复发分组;12岁以内儿童塑型性支气管炎复发风险影响因素单因素分析以及多因素分析。12岁以内儿童塑型性支气管炎复发风险预测模型构建及预测效能分析。结果 本研究纳入111例患儿塑型性支气管炎复发38例,复发率为34.23%。单因素分析结果显示,病变累及肺叶数量、塑型物取出后是否需行有创通气、是否合并肺外多脏器功能损伤均与12岁以内儿童塑型性支气管炎复发有关（P<0.05）。Logistic多因素分析结果显示,病变累及肺叶数量、塑型物取出后是否需行有创通气及是否合并肺外多脏器功能损伤均是12岁以内儿童塑型性支气管炎复发风险独立影响因素。利用Logistic回归模型的独立影响因素以及回归模型预测概率对12岁以内儿童塑型性支气管炎复发的情况进行受试者工作特征（receiver operating characteristic,ROC）曲线的预测,曲线下面积分别为0.693,0.669,0.702,0.849。结论 12岁以内儿童塑型性支气管炎复发可能与病变累及肺叶数量、塑型物取出后是否需行有创通气及是否合并肺外多脏器功能损伤等因素有关;利用以上3个因素构建的数据模型对于患儿的复发预测显示出良好的效能,值得在工作中深入分析。
Abstract
Objective To investigate the risk factors of recurrent plastic bronchitis in children under 12 years old and further construct a clinical prediction model to provide more reference for early identification of children at high risk of recurrence and follow-up diagnosis and treatment. Methods 111 children with plastic bronchitis diagnosed and treated in our hospital from January 2016 to January 2024 were retrospectively included and grouped according to whether children had recurrence or not after 8 weeks of follow-up. Univariate and multivariate analysis of the risk factors of recurrent plastic bronchitis in children under 12 years old. Construction of a risk prediction model for recurrence of plastic bronchitis in children under 12 years of age and analysis of its predictive efficacy. Results In this study, 38 of 111 children with plastic bronchitis relapsed, with a recurrence rate of 34.23%. The results of univariate analysis showed that the cumulative number of pulmonary lesions, the need for invasive ventilation after plastic removal, and the combination of multiple organ function injury were related to the recurrence of plastic bronchitis in children under 12 years old. Logistic multivariate analysis results confirmed that the number of lung lobe involved, whether invasive ventilation was required after plastic removal, and whether multiple organ function injury combined with extra pulmonary injury were independent factors influencing the recurrence risk of plastic bronchitis in children under 12 years old (P<0.05). The independent influencing factors in logistic regression model and the prediction probability of the regression model were used to predict the recurrence of plastic bronchitis in children under 12 years old. The area under the curve was 0.693, 0.669, 0.702 and 0.849, respectively. Conclusion The recurrence of plastic bronchitis in children under 12 years old may be related to the number of lung lobe involved, whether invasive ventilation is required for the first plastic removal, and whether it is complicated with extra pulmonary multiple organ function injury. The data model constructed by using the above three factors has shown good efficacy in predicting the recurrence of children, which is worthy of further analysis in our work.
关键词
儿童 /
塑型性支气管炎 /
复发 /
影响因素 /
模型
Key words
children /
plastic bronchitis /
recurrence /
influencing factors /
model
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参考文献
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基金
陕西省卫生健康科研基金项目“HFNC在儿童重症肺炎治疗中的应用研究”（2021D054）
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