| 唐晓明,赵 丽,赫连静靓,吕月华,李 婷.重症病毒性脑炎患儿预后不良的危险因素及预测模型的构建与评价[J].,2023,(23):4496-4500 |
| 重症病毒性脑炎患儿预后不良的危险因素及预测模型的构建与评价 |
| The Risk Factors for Poor Prognosis of Children with Severe Viral Encephalitis and Construction and Evaluation of the Predictive Model |
| 投稿时间：2023-05-16 修订日期：2023-06-12 |
| DOI：10.13241/j.cnki.pmb.2023.23.019 |
| 中文关键词: 重症 病毒性脑炎 儿童 预后不良 危险因素 预测模型 |
| 英文关键词: Severe Viral encephalitis Children Poor prognosis Risk factors Predictive model |
| 基金项目:江苏省妇幼保健协会科研项目（FYX20200428） |
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| 中文摘要: |
| 摘要 目的：探讨重症病毒性脑炎（SVE）患儿预后不良的危险因素并构建和评价其预测模型。方法：选取2021年1月～2022年5月我院收治的120例SVE患儿，根据6个月后的儿童格拉斯哥预后评分量表（CGOS）评分将其分为预后不良组和预后良好组。收集SVE患儿临床资料，采用多因素Logistic回归分析SVE患儿预后不良的危险因素并构建其预测模型，采用受试者工作特征（ROC）曲线分析SVE患儿预后不良预测模型的预测价值。结果：120例SVE患儿预后不良发生率为42.50%（51/120）。预后不良组病程和发热、惊厥持续时间长于预后良好组，惊厥、应激性高血糖、中重度脑电图异常比例高于预后良好组，脑脊液降钙素原（PCT）、C反应蛋白（CRP）水平高于预后良好组（P＜0.05）。多因素Logistic回归分析显示，病程、发热持续时间及惊厥持续时间延长、应激性高血糖、中重度脑电图异常和PCT、CRP升高为SVE患儿预后不良的独立危险因素（P＜0.05）。SVE患儿预后不良预测模型方程：y＝－16.463＋0.376×病程＋0.198×发热持续时间＋0.353×惊厥持续时间＋0.661×应激性高血糖＋1.305×中重度脑电图异常＋0.662×PCT＋0.071×CRP，该模型H-L检验P＞0.05。ROC曲线分析显示，该预测模型预测SVE患儿预后不良的曲线下面积为0.938，敏感度和特异度分别为82.35%、93.51%。结论：病程、发热持续时间、惊厥持续时间、应激性高血糖、脑电图异常、PCT、CRP为SVE患儿预后不良的影响因素，基于上述危险因素构建的预测模型对SVE患儿预后不良的预测价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the risk factors for poor prognosis of children with severe viral encephalitis (SVE) and construction and evaluation of the predictive model. Methods: 120 children with SVE who were admitted to our hospital from January 2021 to May 2022 were selected, and they were divided into poor prognosis group and good prognosis group according to the Children's Glasgow Outcome Scale (GOS) scores after 6 months. The clinical data of children with SVE were collected, and the risk factors for poor prognosis of children with SVE were analyzed by multivariate Logistic regression and the predictive model was constructed, and the predictive value of the predictive model for poor prognosis of children with SVE were analyzed by receiver operating characteristic (ROC) curve. Results: The incidence of poor prognosis of 120 children with SVE was 42.50% (51/120). The course of disease and the duration of fever and convulsions of poor prognosis group were longer than those of good prognosis group, and the proportion of convulsions, stress hyperglycemia and moderate to severe electroencephalogram abnormalities were higher than those of good prognosis group, and the levels of cerebrospinal fluid procalcitonin (PCT) and C-reactive protein (CRP) were higher than those of good prognosis group (P<0.05). Multifactorial Logistic regression analysis showed that the course of disease, duration of fever and duration of convulsion prolonged, stress hyperglycemia, moderate to severe electroencephalogram abnormalities and PCT and CRP increased were independent risk factors for poor prognosis of children with SVE (P<0.05). The predictive model equation for poor prognosis of children with SVE was y=－16.463+0.376×course of disease+0.198 × duration of fever+0.353× duration of convulsions+0.661×stress hyperglycemia+1.305×moderate to severe electroencephalogram abnormalities+0.662×PCT+0.071×CRP, H-L test of this model P>0.05. ROC curve analysis showed that the predictive model predicted that the area under the curve for poor prognosis of children with SVE was 0.938, sensitivity and specificity was 82.35% and 93.51% respectively. Conclusion: Course of disease, duration of fever, duration of convulsions, stress hyperglycemia, electroencephalogram abnormalities, PCT and CRP are risk factors for poor prognosis of children with SVE, and the predictive model construct base on the above risk factors have high predictive value for poor prognosis of children with SVE. |
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