• 主题
高级搜索  >
历史搜索 清空历史
首页> 中文期刊> 《临床儿科杂志》 >手足口病心肺衰竭危险因素分析及其风险评分模型的建立

手足口病心肺衰竭危险因素分析及其风险评分模型的建立

         
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

目的 分析手足口病患儿心肺衰竭危险因素,建立风险模型及风险评分系统,为心肺衰竭患儿的早期识别和早期治疗提供依据.方法 回顾性分析2010年10月 - 2011年9月住院的199例手足口病患儿的临床资料.患儿分为心肺衰竭组和非心肺衰竭组.以性别、年龄、最高体温、心率、呼吸、血压、EV71感染、皮疹、嗜睡、频繁呕吐、呼吸节律、肢体无力、抽搐、出现皮疹至神经系统受累时间、外周血白细胞计数、淋巴细胞百分比、随机血糖等17项临床指标作为发生心肺衰竭的可能影响因素,利用单因素分析进行筛选,然后多因素Logistic回归分析,在此基础上建立风险模型并进行预测,用灵敏度、特异度、一致率和ROC曲线下面积来评价模型的预测效果.结果 经多因素分析,最高体温、频繁呕吐、随机血糖和呼吸节律不规整4个因素为手足口病发生心肺衰竭的独立危险因素,根据多因素Logistic回归分析的结果建立Logistic回归预测模型.对模型的预测概率进行ROC曲线分析,曲线下面积为0.994.根据该模型,对现有的数据进行预测,模型的敏感度为94.12%(64/68),特异度为97.71%(128/132),一致率为94.48%(192/199).结论 手足口病心肺衰竭模型可定量评估手足口病患儿发生心肺衰竭的风险.%Objective To investigate the risk factors for cardiorespiratory failure in infants with hand,foot and mouth disease, and to develop a reliable prediction system for the early diagnosis and management of the severe patients. Methods One hundred and ninety-nine hospitalized infants with hand,foot and mouth disease were enrolled. The patients were divided into two groups based on presence and absence of cardiorespiratory failure. Based on available documents, 17 clinical measures were studied as the possible risk factors,including gender,age,the highest temperature, heart rate,respiratory rate,blood pressure,EV71 infection,rashes,drowsiness,vomiting,abnormal respiratory rhythm,limb asthenia, convulsion, the time from eruption of skin rash or oral ulcer to the appearance of central nervous system symptoms, peripheral blood leukocytes, percentage of lymphocyte, and random glucose level. Logistic regression was used to examine the relationship between risk factors and cardiorespiratory failure. A risk score model was built according to the above factors. The predictive effect of the model was evaluated by sensitivity, specificity, consistency and area under receiver operating characteristic (ROC)curve. Results In the multivariable analysis,4 variables in the risk evaluation model (the highest temperature, vomiting, random glucose level and abnormal respiratory rhythm) remained independent predictors of the outcome. The risk score model highly predicted cardiorespiratory failure. The area under the ROC curve for the evaluation model was 0.994. When the prediction was performed based on the existing date using the presut model, the sensitivity,specificity and consistency of the model were 94.12%(64/68) ,97.71%(128/132)and 94.48%( 192/199), respectively. Conclusions The risk score model was a quantitative and effective tool for predicting cardiorespiratory failure in infants with hand,foot and mouths disease.

著录项

  • 来源
    《临床儿科杂志》 |2012年第6期|519-524|共6页
  • 作者

    付海燕; 石伟娜; 王晓明; 赵欣; 刘俊莹; 殷润开; 殷春兰; 贾彬; 李海花; 张静;

  • 作者单位

    河北省儿童医院感染消化科,河北石家庄,050031;

    河北省儿童医院感染消化科,河北石家庄,050031;

    河北省儿童医院感染消化科,河北石家庄,050031;

    河北省儿童医院感染消化科,河北石家庄,050031;

    河北省儿童医院感染消化科,河北石家庄,050031;

    河北省儿童医院感染消化科,河北石家庄,050031;

    河北省儿童医院感染消化科,河北石家庄,050031;

    河北省儿童医院感染消化科,河北石家庄,050031;

    河北省儿童医院感染消化科,河北石家庄,050031;

    河北省儿童医院感染消化科,河北石家庄,050031;

  • 原文格式 PDF
  • 正文语种 chi
  • 中图分类 小儿内科学;
  • 关键词

    手足口病; 心肺衰竭; 危险因素; 模型; 统计学;

相似文献

  • 中文文献
  • 外文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号