Analysis of factors influencing the efficacy of methylprednisolone in the treatment of henoch-sch?nlein purpura and construction of Nomogram prediction model
Objective To investigate the factors influencing the efficacy of methylprednisolone in the treatment of he-noch-schönlein purpura(HSP)and to construct a Nomogram prediction model.Methods The data of children with severe HSP admitted to Suining Central Hospital from May 2021 to April 2023 were retrospectively selected and divided into the group with good efficacy and the group with poor efficacy according to the efficacy of methylprednisolone in treating HSP.Clinical data of the children were collected,and the optimal cut-off values of each factor were obtained through the analysis of sub-jects'work characteristics(ROC)curves.A logistic multiple regression model was used to analyze the risk factors affecting the efficacy of methylprednisolone in treating HSP.A Nomogram prediction model was constructed,and the internal validation and prediction efficacy were evaluated by the calibration curve and the decision curve respectively.Results A total of 227 pa-tients with severe HSP were included in this study,including 176 patients in the group with good efficacy and 51 patients in the group with poor efficacy.The age of the group with good efficacy,the inducing factors of infection ratio,previous HSP history ratio,HSP family history ratio,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and systemic immu-noinflammatory index(SII)were all higher than those of the group with good efficacy.Dietary intervention ratio and IgG level were lower than those of the group with good efficacy with statistically significant differences(P<0.05).ROC results showed that the optimal cut-off values of age,IgG,NLR,PLR,and SII were 7 years old,9.34 g/L,3.58,215.45,and 726.75,re-spectively.Logistic multivariate regression showed that age,previous HSP history,family history of HSP,NLR,PLR,and SII were the risk factors affecting the therapeutic effect of methylprednone on HSP,and dietary intervention was the protective fac-tor(P<0.05).Internal verification results showed that the C-index of the Nomogram model was 0.925(0.881 to 0.970),and the actual and predicted values were basically consistent.The Nomogram model threshold was greater than 0.08,indica-ting that the model provided significant clinical net benefits.Conclusion The Nomogram prediction model constructed based on age,previous history of HSP,family history of HSP,NLR,PLR,and SII has good predictive value for the efficacy of methyl-prednisolone in the treatment of HSP,which may provide a basis for improving the efficacy of HSP.
methylprednisolonehenoch-schönlein purpuraefficacyNomogram prediction model
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