郭丽敏, 冯仕品, 刘喜, 李佳. 过敏性紫癜患儿肾损伤发生危险因素及列线图构建[J]. 临床肾脏病杂志, 2022, 22(2): 100-105. DOI: 10.3969/j.issn.1671-2390.2022.02.003
    引用本文: 郭丽敏, 冯仕品, 刘喜, 李佳. 过敏性紫癜患儿肾损伤发生危险因素及列线图构建[J]. 临床肾脏病杂志, 2022, 22(2): 100-105. DOI: 10.3969/j.issn.1671-2390.2022.02.003
    GUO Li-min, FENG Shi-pin, LIU Xi, LI Jia. Risk factors and nomogram of renal injury in children with Henoch Schonlein purpura[J]. Journal of Clinical Nephrology, 2022, 22(2): 100-105. DOI: 10.3969/j.issn.1671-2390.2022.02.003
    Citation: GUO Li-min, FENG Shi-pin, LIU Xi, LI Jia. Risk factors and nomogram of renal injury in children with Henoch Schonlein purpura[J]. Journal of Clinical Nephrology, 2022, 22(2): 100-105. DOI: 10.3969/j.issn.1671-2390.2022.02.003

    过敏性紫癜患儿肾损伤发生危险因素及列线图构建

    Risk factors and nomogram of renal injury in children with Henoch Schonlein purpura

    • 摘要: 目的 通过分析过敏性紫癜患儿肾损伤发生的相关影响因素,建立并评估个体化预测过敏性紫癜患儿肾损伤发生风险的列线图模型。方法 选取2017年5月至2020年2月在电子科技大学医学院附属妇女儿童医院确诊并接受治疗的过敏性紫癜患儿180例为研究对象,并根据过敏性紫癜患儿是否发生肾损伤将其分为肾损伤组(48例)和未肾损伤组(132例)。采用Logistic回归模型,分析过敏性紫癜患儿肾损伤发生的相关影响因素。应用列线图在线网站绘制预测过敏性紫癜患儿肾损伤发生风险的列线图模型。采用研究对象工作特征曲线(receiver operator characteristic curve,ROC)、校准曲线及Hosmer-Lemeshow拟合优度检验评估列线图模型进行验证。结果 Logistic回归模型显示,合并呼吸道病原体感染、EB病毒感染、中性粒细胞和淋巴细胞比值≥6.11、血小板计数≥302.16×109/L、D-二聚体≥543.07µg/L水平是过敏性紫癜患儿肾损伤发生的独立危险因素(P<0.05)。ROC结果显示,预测过敏性紫癜患儿肾损伤发生风险的AUC为0.882。校准曲线为斜率接近为1的直线,Hosmer-Lemeshow拟合优度检验χ2=6.627,P=0.577。结论 本研究基于呼吸道病原体感染、EB病毒感染、中性粒细胞和淋巴细胞比值、血小板计数、D-二聚体水平这5项影响过敏性紫癜患儿肾损伤发生的独立危险因素构建的预测过敏性紫癜患儿肾损伤发生风险的列线图模型,具有良好的区分度与准确度。

       

      Abstract: Objective To establish and evaluate an individual nomogram model for predicting the risk of renal injury through analyzing the related influencing factors in Henoch Schonlein purpura(HSP) children.Methods From May 2017 to February 2020,a total of 180 hospitalized HSP children were selected as research subjects. Based upon the presence or absence of renal injury,they were divided into two groups of renal injury(n=48) and non-renal injury(n=132). Logistic regression model was utilized for analyzing the related factors of renal injury. Nomogram online website was employed for plotting a nomogram model to predict the risk of renal injury. Receiver operator characteristic curve(ROC),calibration curve and Hosmer-Lemeshow goodness-of-fit test were used for evaluating the nomogram model.Results Logistic regression model indicated that respiratory tract pathogen infection,Epstein Barr virus infection,neutrophil-to-lymphocyte ratio ≥ 6.11,platelet count ≥ 302.16×109/L and D-dimer ≥ 543.07µg/L levels were independent risk factors of renal injury(P<0.05). ROC results showed that the area under cruve(AUC) of predicting the risk of renal injury was 0.882. And calibration curve revealed a straight line with a slope of close to 1. Hosmer-Lemeshow goodness-of-fit test showed χ2=6.627,P=0.577.Conclusions Based upon five independent risk factors of renal injury,including respiratory tract pathogen infection,Epstein Barr virus infection,neutrophil-to-lymphocyte ratio,platelet count,D-dimer levels,nomogram modeling for predicting the risk of renal injury offers decent discrimination and accuracy in HSP children.

       

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