广东医学2025，Vol.46Issue(1)：8-14,7.DOI:10.13820/j.cnki.gdyx.20242324
基于肺部超声及临床分子特征列线图预测儿童难治性肺炎支原体肺炎
Predicting refractory mycoplasma pneumoniae pneumonia in children using lung ultrasound and clinical molecu-lar features:A nomogram approach
摘要
Abstract
Objective The early diagnosis of refractory mycoplasma pneumoniae pneumonia(RMPP)is chal-lenging due to the lack of practical diagnostic imaging tools.Pulmonary ultrasound(LUS)is an emerging tool for diagno-sing pneumonia in children.This study aimed to evaluate the role of a nomogram,combining LUS,clinical features,and laboratory markers,in predicting early RMPP in children.Methods A total of 300 children with mycoplasma pneumonia were prospectively enrolled.The cohort was divided into a modeling group(200 children)and a validation group(100 children)with a 2∶1 ratio.The modeling group included 159 cases of typical mycoplasma pneumonia(CMPP)and 41 ca-ses of RMPP,while the validation group comprised 81 cases of CMPP and 19 cases of RMPP.A binary logistic regression analysis was used to assess factors influencing the occurrence of RMPP.Significant variables identified by univariate analy-sis were incorporated into a multivariate logistic regression model to identify independent risk factors for RMPP.The resul-ting predictive model was converted into a visual nomogram.The model's accuracy was evaluated using receiver operating characteristic(ROC)curves,and its calibration was assessed using calibration curves.Results Independent risk factors for RMPP included age(OR=1.286,95％CI:1.031-1.639,P=0.031),duration of fever before admission(OR=1.630,95％CI:1.248-2.219,P＜0.001),high fever(OR=3.650,95％CI:0.889-18.230,P=0.089),erythro-cyte sedimentation rate(ESR)(OR=1.056,95％CI:1.027-1.090,P＜0.001),and bronchial hyperinflation(OR=104.526,95％CI:16.433-1 319.111,P＜0.001).The nomogram for predicting RMPP was visually represented,with an area under the ROC curve(AUC)of 0.943(95％CI:0.908-0.977)in the modeling group and 0.966(95％CI:0.937-0.997)in the validation group.The calibration curves were close to the diagonal line,suggesting good clinical applicability.Conclusion The inclusion of LUS in the nomogram provides a more comprehensive assessment of disease status,enabling more accurate early prediction of RMPP in children.Therefore,this predictive model could be widely ap-plied in the early diagnosis of RMPP in pediatric patients.关键词
儿童难治性肺炎支原体肺炎/肺部超声/预测模型/列线图Key words
pediatric refractory mycoplasma pneumonia/pulmonary ultrasound/prediction model/nomogram分类
医药卫生引用本文复制引用
邓春燕,潘代,刘贺临,郑申建,朱婷,张海燕..基于肺部超声及临床分子特征列线图预测儿童难治性肺炎支原体肺炎[J].广东医学,2025,46(1):8-14,7.基金项目
孝感市自然科学基金项目(XGKJ2023010009) （XGKJ2023010009）
湖北儿科联盟医学科研项目(HPAMRP202413) （HPAMRP202413）
