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早产儿早发败血症影响因素及列线图模型构建

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目的 分析早产儿早发败血症的影响因素,并构建列线图预测模型.方法 收集2020年1月~2021年12月山西省儿童医院(山西省妇幼保健院)收治的124例新生儿早发败血症患儿的临床资料,根据胎龄将新生儿分为早产儿组(n=33)和足月儿组(n=91),比较两组患儿的临床特征,并建立列线图预测模型,对模型的预测性及准确度进行内部验证.结果 与足月儿组比较,早产儿组女性比例高(x2=7.147,P<0.05);1min Apgar评分低(x2=-3.398,P<0.05);围生期孕妇有妊娠合并症的比例高(x2=7.846,P<0.05);肺炎和反应差的发生率均高(x2=18.210,P<0.05;x2=14.814,P<0.05);黄疸的发生率低(x2=10.400,P<0.05).多因素Logistic回归分析结果显示,女性、患肺炎是早产儿早发败血症的危险因素(P<0.05).列线图模型结果显示,模型C指数为0.886.预测发生率与实际发生率基本一致,受试者工作特征曲线下面积为0.886,决策曲线显示阈值概率在4%~100%时具有较高的净获益值.结论 女性、患肺炎早产儿早发败血症的风险较高.本研究构建的早产儿早发败血症列线图模型具有较高的临床价值,可为临床预防早产儿早发败血症提供参考依据.
Factors Affecting Early-onset Sepsis in Preterm Infants and Construction of Nomogram Model
Objective To analyze the factors influencing early-onset sepsis in preterm infants and construct nomogram model.Methods A total of 124 neonates with premature sepsis admitted to Shanxi Children's Hospital(Shanxi Maternal and Child Health Hos-pital)from January 2020 to December 2021 were collected.According to gestational age,the neonates were divided into premature group(n=33)and full-term group(n=91),and the clinical characteristics of the two groups were compared,and nomogram model was es-tablished to internally validate the predictiveness and accuracy of the model.Results Compared with the full-term group,the proportion of females in premature group was higher(x2=7.147,P<0.05),the 1min Apgarscore in premature group was lower(x2=-3.398,P<0.05),the proportion of perinatal mothers with pregnancy complications in premature group was higher(x2=7.846,P<0.05),the incidence of pneumonia and poor response in preterm infants of premature group were higher(x2=18.210,P<0.05;x2=14.814,P<0.05),but the incidence of jaundice in premature group was lower(x2=10.400,P<0.05).Multivariate Logistic regression analysis showed that female and pneumonia were risk factors for early-onset sepsis in preterm infants(P<0.05).The results of the nomogram model showed that the C-index of the model was 0.886.The predicted incidence was generally consistent with the actual incidence,the area under the receiver operator characteristic curve was 0.886,and the decision curve showed a high net benefit value at threshold proba-bilities of 4%-100%.Conclusion Female,preterm infants with pneumonia have a higher risk of early-onset sepsis.The nomogram model of premature sepsis constructed in this study has high clinical value and can provide a reference basis for clinical prevention of early-onset sepsis in preterm infants.

Early-onset sepsisPremature infantTerm infantNomogram

弓培慧、贾晓云、申嘉欣、张岳琴、李秀辉、康娅楠、周浩、白丽霞

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030001 太原,山西医科大学流行病学教研室

030001 太原,山西医科大学第二医院

030013 太原,山西省儿童医院(山西省妇幼保健院)

早发败血症 早产儿 足月儿 列线图

山西省重点研发计划项目

201903D321173

2024

医学研究杂志
中国医学科学院

医学研究杂志

CSTPCD
影响因子:0.702
ISSN:1673-548X
年,卷(期):2024.53(2)
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