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一种用于预测原发性免疫性血小板减少症患者诊断后 6 个月内呼吸道感染风险的列线图模型。

A Nomogram Model for Individualized Prediction of the Risk of Respiratory Tract Infection within Six Months after Diagnosis in Patients with Primary Immune Thrombocytopenia.

机构信息

Department of Hematology, Department of Rheumatology and Immunology, The People's Hospital of Hechi, Hechi, 547000 Guangxi, China.

Department of Gynecology, The People's Hospital of Hechi, Hechi, 547000 Guangxi, China.

出版信息

Comput Math Methods Med. 2022 Jul 28;2022:5002681. doi: 10.1155/2022/5002681. eCollection 2022.

Abstract

The risk factors of upper respiratory tract infection (URI) within 6 months after diagnosis in patients with idiopathic thrombocytopenic purpura (ITP) were analyzed, and the nomogram model was established and verified, with 242 and 50 ITP patients as the training and validation set, respectively. The patients were followed up for six months after the diagnosis of ITP. The clinical data of patients were collected, and the risk factors of URI in ITP patients within six months after diagnosis were analyzed using univariable, followed by multivariable logistic regression. Among the 242 ITP patients in the training set, 52 cases (21.49%) had URI, including 24 cases of viral infection, 11 cases of Mycoplasma pneumoniae infection, and 17 cases of bacterial infection. Logistic regression analysis showed that advanced age, use of glucocorticoid, smoking history, platelet count, serum CRP level, and lymphocyte subsets CD and CD were all risk factors for ITP patients to develop symptoms within six months after diagnosis ( < 0.05). Using the above five indicators, a nomogram prediction model was built for URI occurrence in patients with ITP within half a year after diagnosis, and the results showed an AUC, a sensitivity, and a specificity of 0.936 (95% CI: 0.878-0.983), 0.942, and 0.865, respectively. The nomogram model was internally verified by the bootstrap method for 500 self-sampling times, and the prediction of the calibration curve was in high consistency with the real results. External validation of the nomogram model resulted in an AUC, a sensitivity, and a specificity of 0.890 (95% CI: 0.757-0.975), 0.949, and 0.727, respectively. The nomogram model of URI in ITP patients within half a year after diagnosis based on logistic regression analysis has good discrimination and prediction accuracy. This provides important guidance value for individualized prediction of URI in ITP patients.

摘要

分析了特发性血小板减少性紫癜(ITP)患者诊断后 6 个月内上呼吸道感染(URI)的危险因素,并建立和验证了列线图模型,分别使用 242 例和 50 例 ITP 患者作为训练集和验证集。患者在 ITP 诊断后进行了 6 个月的随访。收集患者的临床资料,采用单变量和多变量逻辑回归分析 ITP 患者诊断后 6 个月内 URI 的危险因素。在训练集中的 242 例 ITP 患者中,52 例(21.49%)发生 URI,其中病毒感染 24 例,肺炎支原体感染 11 例,细菌感染 17 例。Logistic 回归分析显示,高龄、使用糖皮质激素、吸烟史、血小板计数、血清 CRP 水平和淋巴细胞亚群 CD 和 CD 是 ITP 患者在诊断后 6 个月内出现症状的危险因素(<0.05)。使用上述 5 个指标,建立了 ITP 患者诊断后半年内发生 URI 的列线图预测模型,结果显示 AUC、灵敏度和特异性分别为 0.936(95%CI:0.878-0.983)、0.942 和 0.865。该列线图模型通过 500 次自采样的 Bootstrap 方法进行内部验证,校准曲线的预测与真实结果高度一致。列线图模型的外部验证结果显示 AUC、灵敏度和特异性分别为 0.890(95%CI:0.757-0.975)、0.949 和 0.727。基于逻辑回归分析的 ITP 患者诊断后半年内 URI 的列线图模型具有良好的判别和预测准确性。这为 ITP 患者 URI 的个体化预测提供了重要的指导价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2886/9352501/8895702d30a9/CMMM2022-5002681.001.jpg

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