Shen Ziyun, Hao Qingfei, Yang Tiantian, Cheng Xiuyong
Department of Neonatology, The First Affiliated Hospital of Zheng Zhou University, Zhengzhou, China.
Front Pediatr. 2025 Jan 7;12:1440437. doi: 10.3389/fped.2024.1440437. eCollection 2024.
To explore the risk factors for the reactivate of retinopathy of prematurity (ROP) after intravitreal injection of anti-vascular endothelial growth factor (VEGF) and to construct a nomogram model to predict the risk of ROP reactivate.
A retrospective analysis was conducted on 185 ROP children who underwent anti-VEGF treatment at the First Affiliated Hospital of Zhengzhou University from January 2017 to October 2023. They were randomly divided into a training set (129 cases) and a validation set (56 cases) at a ratio of 7:3. The training set was further divided into a reactivate group ( = 18) and a non-reactivate group ( = 111) based on whether ROP recurred after treatment. Multivariable logistic regression analysis was used to screen for risk factors for ROP reactivate. A nomogram model was constructed using R software and validated using the validation set. The discrimination, calibration, and clinical net benefit of the model were evaluated using the receiver operating characteristic curve (ROC curve), calibration curve, and decision curve analysis, respectively.
Multivariable logistic regression analysis showed that the number of red blood cell transfusions, use of pulmonary surfactant (PS) 2 times or more, and preoperative fundus hemorrhage were independent risk factors for ROP reactivate ( < 0.05). The area under the ROC curve (AUC) of the training set was 0.810 (95% CI: 0.706-0.914), and that of the validation set was 0.756 (95% CI: 0.639-0.873). The Hosmer-Leme show goodness-of-fit test indicated a good fit of the model ( = 0.31). Calibration curve analysis and decision curve analysis suggested high predictive efficacy and clinical application value of the model.
The number of red blood cell transfusions, use of PS 2 times or more, and preoperative fundus hemorrhage are independent risk factors for ROP reactivate. The nomogram model constructed based on these factors has high predictive efficacy and clinical application value.
探讨玻璃体内注射抗血管内皮生长因子（VEGF）后早产儿视网膜病变（ROP）复发的危险因素，并构建列线图模型以预测ROP复发风险。
对2017年1月至2023年10月在郑州大学第一附属医院接受抗VEGF治疗的185例ROP患儿进行回顾性分析。按7:3的比例随机分为训练集（129例）和验证集（56例）。根据治疗后ROP是否复发，将训练集进一步分为复发组（=18）和未复发组（=111）。采用多变量logistic回归分析筛选ROP复发的危险因素。使用R软件构建列线图模型，并使用验证集进行验证。分别采用受试者操作特征曲线（ROC曲线）、校准曲线和决策曲线分析评估模型的辨别力、校准度和临床净效益。
多变量logistic回归分析显示，红细胞输血次数、2次及以上使用肺表面活性物质（PS）和术前眼底出血是ROP复发的独立危险因素（<0.05）。训练集的ROC曲线下面积（AUC）为0.810（95%CI：0.706-0.914），验证集的为0.756（95%CI：0.639-0.873）。Hosmer-Leme显示拟合优度检验表明模型拟合良好（=0.31）。校准曲线分析和决策曲线分析表明该模型具有较高的预测效能和临床应用价值。
红细胞输血次数、2次及以上使用PS和术前眼底出血是ROP复发的独立危险因素。基于这些因素构建的列线图模型具有较高的预测效能和临床应用价值。
