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ABO血型系统新生儿溶血病患病风险预测模型构建与验证

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目的 构建ABO血型系统新生儿溶血病(ABO-HDN)患病风险预测模型,并验证其有效性.方法 选取2022年1月至2023年3月在该院首诊为新生儿高胆红素血症且符合纳入标准的446例患儿作为建模组,根据是否确诊ABO-HDN分为发生组(200例)和未发生组(246例).纳入17个潜在影响因素进行单因素分析和多因素分析,将独立危险因素纳入R软件,以建立列线图模型来预测ABO-HDN的发生风险.另选取2023年4-9月该院105例新生儿高胆红素血症患儿作为验证组.结果 建模组中,Logistic回归分析显示,患儿母亲孕次、产前血清效价、血红蛋白水平、白细胞计数、肌酸激酶水平及新生儿Apgar 1 min评分均为新生儿发生ABO-HDN的独立危险因素(P<0.05).多因素Logistic回归分析的列线图模型显示,建模组受试者工作特征(ROC)曲线对应曲线下面积为0.819(95%CI:0.779~0.859),灵敏度为0.655,特异度为0.878;验证组曲线下面积为0.867(95%CI:0.800~0.933),灵敏度为0.803,特异度为0.773.结论 建立的预测模型评分系统能有效预测ABO-HDN的发生风险.
Construction and verification of neonatal ABO-blood group system hemolytic disease of the newborn risk prediction model
Objective To construct a model that can predict the risk of diagnosing ABO-blood group sys-tem hemolytic disease of the newborn(ABO-HDN)and to verify its effectiveness.Methods A total of 446 children with neonatal hyperbilirubinemia who met the inclusion criteria and were first diagnosed in this hos-pital from January 2022 to March 2023 were selected as the modeling group,and were divided into the develo-ping group(200 cases)and the non-developing group(246 cases)according to whether ABO-HDN was diag-nosed.Totally 17 potential influencing factors were included for univariate analysis and multi-factor analysis,and independent risk factors were included in R software to establish a Nomogram model to predict the risk of ABO-HDN.Another 105 cases of neonatal hyperbilirubinemia in the hospital from April to September 2023 were selected as the verification group.Results In the modeling group,Logistic regression analysis showed that maternal pregnancy number,prenatal serum titer,hemoglobin level,white blood cell count,creatine ki-nase level and neonatal Apgar 1 min score were all independent risk factors for ABO-HDN(P<0.05).Multi-variate Logistic regression analysis showed that the area under receiver operating characteristic(ROC)curve of the modeling group was 0.819(95%CI:0.779-0.859),sensitivity was 0.655,specificity was 0.878.In the verification group,the area under ROC curve was 0.867(95%CI:0.800-0.933),the sensitivity was 0.803,and the specificity was 0.773.Conclusion The established predictive model scoring system can effec-tively predict the risk of ABO-HDN.

ABO blood typehemolytic disease of the newbronrisk factorsprediction modelexternal verification

李娲、谭琪琳、吴旭良、文依敏、廖秀娟、黄灼宏

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广州医科大学附属妇女儿童医疗中心,广州广东 511300

ABO血型 新生儿溶血病 危险因素 预测模型 外部验证

2025

国际检验医学杂志
重庆市卫生信息中心

国际检验医学杂志

影响因子:1.013
ISSN:1673-4130
年,卷(期):2025.46(1)