新医学2024，Vol.55Issue(10)：801-809,9.DOI:10.3969/j.issn.0253-9802.2024.10.007
过敏性哮喘患儿螨SCIT不良反应预测模型的构建与验证
Construction and validation of a predictive model for adverse reactions to mite subcutaneous immunotherapy in children with allergic asthma
摘要
Abstract
Objective To construct a nomogram prediction model for adverse reactions of mite sublingual immunotherapy(SCIT)in children with allergic asthma,and to evaluate and validate it.Methods Clinical data of children with allergic asthma who were managed by mite SCIT in Department of Pediatrics,the Second Hospital of Tianjin Medical University were retrospectively analyzed.According to the adverse reactions in the initial treatment stage of SCIT,they were divided into adverse reaction group and no adverse reaction group,which together formed the modeling group.Through univariate logistic regression analysis and multivariate logistic regression analysis,independent risk factors were screened out.Then construct the prediction model,draw a nomogram,eventually evaluate and validate the model.Results A total of 350 children were included,including 176 in the adverse reaction group and 174 in the no adverse reaction group.Univariate logistic regression analysis was performed on the baseline data of the children in the modeling group,and the results were as follows.Gender,age,number of asthma exacerbations in the past 1 year,percentage of eosinophils(EOS%),forced expiratory volume in the first second in percent predicted values(FEV1%pred),total IgE(tIgE),dermatophagoides pteronyssinus(Der p)sIgE,dermatophagoides farinae(Der p)sIgE,and the number of other inhaled allergenic species were the risk factors of SCIT-related adverse reactions(all P<0.1).These were included in the multivariate logistic regression analysis,and the results showed that:age,the number of asthma exacerbations in the past 1 year,tIgE,Der p sIgE,Der f sIgE,and the number of other inhaled allergen species were independent risk factors(all P<0.05).Based on the results,nomogram was drawn in R language.Model evaluation by receiver operating characteristic curve showed an area under curve of 0.877,a predictive model sensitivity of 73.9%,and a specificity of 90.8%.The predicted probability was consistent with actual probability of occurrence.The model has good prediction performance.Conclusions Age,number of asthma exacerbations in the past 1 year,tIgE,Der p sIgE,Der f sIgE,and the number of other inhaled allergen species were independent risk factors for adverse reactions to mite SCIT in children.The nomogram drawn in this study has good predictive value.关键词
过敏原免疫治疗/舌下含服免疫治疗/不良反应/过敏性哮喘/儿童/诺莫图/预测模型Key words
Allergen immunotherapy/Sublingual immunotherapy/Adverse reactions/Allergic asthma/Children/Nomogram/Predictive model引用本文复制引用
孙鑫雨,刘长山,王雪艳..过敏性哮喘患儿螨SCIT不良反应预测模型的构建与验证[J].新医学,2024,55(10):801-809,9.基金项目
天津市科技计划项目(22KPHDRC00280) （22KPHDRC00280）
