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用于预测过敏性紫癜患儿复发的列线图的开发与验证

Development and validation of a nomogram to predict recurrence in children with Henoch-Schönlein purpura.

作者信息

Song Danyang, Jiang Yajing, Zhao Qiuju, Li Jinling

机构信息

Department of Children's Emergency, Cangzhou Central Hospital Cangzhou 061000, Hebei, China.

Department of Paediatrics, Cangzhou Central Hospital Cangzhou 061000, Hebei, China.

出版信息

Am J Transl Res. 2022 Jul 15;14(7):4688-4697. eCollection 2022.

Abstract

BACKGROUND

To screen risk factors for the recurrence in children with Henoch-Schönlein Purpura (HSP) and to develop and validate a nomogram for recurrence in children with HSP.

METHODS

During September 2019 and September 2021, 212 children with HSP were selected in this study. The children were divided into two sets in a proportion of 7:3 using R language, with the first group as the training sets and the second as the internal validation sets. The related variables were analyzed by univariate and multivariate logistic regression analyses, and a nomogram for predicting the recurrence in HSP children was established. The nomogram was evaluated by ROC curve, calibration curve and decision curve, and 1000 times bootstrap resampling method was used to verify the model internally.

RESULTS

Univariate and multivariate regression analyses identified respiratory infection, without preventive medication and diet restriction, age, allergen positive and abnormal urine routine as risk factors for the recurrence in children with HSP. Those risk factors were used to construct a predictive nomogram. The calibration curves revealed excellent accuracy of the predictive nomogram model, internally and externally.

CONCLUSIONS

We constructed and validated a clinical nomogram to predict the recurrence in children with HSP. We confirmed that respiratory tract infection, without preventive medication and diet restriction, age, allergen positive and abnormal urine routine were independent recurrence risk factors. This nomogram had a good performance in clinical decision-making.

摘要

背景

筛选过敏性紫癜(HSP)患儿复发的危险因素,并开发和验证HSP患儿复发的列线图。

方法

2019年9月至2021年9月,本研究选取212例HSP患儿。使用R语言按7:3的比例将患儿分为两组,第一组作为训练集,第二组作为内部验证集。通过单因素和多因素逻辑回归分析相关变量,建立预测HSP患儿复发的列线图。通过ROC曲线、校准曲线和决策曲线对列线图进行评估,并采用1000次自抽样重采样方法进行内部模型验证。

结果

单因素和多因素回归分析确定呼吸道感染、未进行预防性用药和饮食限制、年龄、过敏原阳性及尿常规异常为HSP患儿复发的危险因素。利用这些危险因素构建了预测列线图。校准曲线显示预测列线图模型在内部和外部均具有出色的准确性。

结论

我们构建并验证了一个预测HSP患儿复发的临床列线图。我们证实呼吸道感染、未进行预防性用药和饮食限制、年龄、过敏原阳性及尿常规异常是独立的复发危险因素。该列线图在临床决策中表现良好。

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本文引用的文献

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Henoch-Schönlein Purpura /IgA Vasculitis Complicated by Coronary Artery Aneurysm: A Case Report and Literature Review.
Front Pediatr. 2022 Feb 3;9:781106. doi: 10.3389/fped.2021.781106. eCollection 2021.
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Integrated Analyses of Gut Microbiome and Host Metabolome in Children With Henoch-Schönlein Purpura.
Front Cell Infect Microbiol. 2022 Jan 25;11:796410. doi: 10.3389/fcimb.2021.796410. eCollection 2021.
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Palpable purpura: is it associated with vasculitis or not? A single-center experience.
Clin Rheumatol. 2022 May;41(5):1493-1498. doi: 10.1007/s10067-022-06075-5. Epub 2022 Jan 25.
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Henoch-Schönlein Purpura in the Elderly-Rare and Deadly.
Am J Gastroenterol. 2022 May 1;117(5):710-711. doi: 10.14309/ajg.0000000000001648. Epub 2022 Jan 12.
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Use of renin-angiotensin system inhibitors as initial therapy in children with Henoch-Schönlein purpura nephritis of moderate severity.
Pediatr Nephrol. 2022 Aug;37(8):1845-1853. doi: 10.1007/s00467-021-05395-z. Epub 2022 Jan 11.

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