中国免疫学杂志2025，Vol.41Issue(4)：943-947,953,6.DOI:10.3969/j.issn.1000-484X.2025.04.028
慢性荨麻疹患儿经西替利嗪联合地氯雷他定治疗后预后的列线图模型构建
Construction of a column chart model for prognosis of children with chronic urticaria treated with cetirizine combined with desloratadine
摘要
Abstract
Objective:To explore the influencing factors of prognosis in children with chronic urticaria treated with cetirizine and desloratadine in combination,and to construct a column chart prediction model.Methods:A total of 182 children with chronic urticaria who underwent cetirizine combined with desloratadine treatment in Hainan Women and Children's Medical Center from January 2019 to December 2021 were selected as study subjects for a one-year follow-up.They were divided into a relapse group(n=51)and a non relapse group(n=131)based on prognosis.Compared the medical records of two groups of children,and conducted independent sample t-test and χ2 to analyze the relevant indicators that affect the recurrence of chronic urticaria in children treated with cetirizine and desloratadine in combination;using MedCalc software,ROC curve analysis was conducted on statistically significant econometric indicators to explore their predictive value for recurrence in children with chronic urticaria treated with cetirizine and desloratadine in combination;independent risk factors for recurrence in children with chronic urticaria after combined use of cetirizine and desloratadine were analyzed by logistic regression analysis;R language software 4.0"rms"package was used to construct a column chart prediction model for the recurrence of chronic urticaria in children after the combination of cetirizine and desloratadine.Column chart prediction model was internally validated and evaluated for clinical predictive efficacy through calibration curve and decision curve.Results:Differences between the two groups of children were statistically significant(P<0.05)in terms of disease duration,history of previous allergic diseases,frequency of attacks,number of wind clusters,duration of wind clusters,mean diameter of wind clusters,IgE,IFN-γ,IL-10,IL-18 and CRP.AUCs for disease duration,episode frequency,number of wind clusters,duration of wind clusters,mean diameter of wind clusters,IgE,IFN-γ,IL-10,IL-18 and CRP were 0.854,0.697,0.739,0.876,0.847,0.767,0.902,0.804,0.829 and 0.850,respectively,and the best cutoff values were 8 months,4 times/week,6,3 h,2.1 cm,149.7 U/ml,27.2 ng/L,3.6 ng/L,40.5 ng/L,2.6 mg/L.Disease duration,IgE,IFN-γ,IL-10,IL-18 and CRP were independent risk factors affecting relapse after cetiri-zine and desloratadine combination in children with chronic urticaria.Calibration curve of the column chart prediction model was closed to the original curve and the ideal curve with a C-index of 0.625(95%CI:0.613～0.702),and the model fit was good;the threshold value of column chart prediction model was>0.16,which could provide a net clinical benefit,and all of the net clinical benefits were higher than those of disease duration,IgE,IFN-γ,IL-10,IL-18 and CRP.Conclusion:This study is based on the inde-pendent risk factors for recurrence in children with chronic urticaria after combined use of cetirizine and desloratadine,including course of disease,IgE,IFN-γ,IL-10,IL-18 and CRP,which have constructed a column chart prediction model to provide reference for the recurrence prediction of children with chronic urticaria,in order to screen high-risk recurrent children as soon as possible and take intervention measures to improve the recurrence situation and quality of life in children with chronic urticaria.关键词
慢性荨麻疹/西替利嗪/地氯雷他定/预后/列线图预测模型Key words
Chronic urticaria/Cetirizine/Desloratadine/Prognosis/Column chart prediction model分类
医药卫生引用本文复制引用
谭茜,王燕,黄冬男..慢性荨麻疹患儿经西替利嗪联合地氯雷他定治疗后预后的列线图模型构建[J].中国免疫学杂志,2025,41(4):943-947,953,6.基金项目
海南省自然科学基金面上项目(818MS170) （818MS170）
海南省临床医学中心建设项目(琼卫医函[2021]75号). （琼卫医函[2021]75号）
