基于临床预测模型的儿童阻塞性睡眠呼吸暂停低通气综合征与分泌性中耳炎相关性研究OA
Association study of pediatric obstructive sleep apnea hypopnea syndrome and otitis media with effusion based on clinical prediction model and Mendelian randomization
目的 探讨儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与分泌性中耳炎(OME)的相关性,为临床诊疗提供循证学依据.方法 收集2019年9月~2025年3月就诊于长治医学院附属和平医院耳鼻咽喉科OSAHS患儿985例.根据是否合并OME,将其分为合并OME组和无OME组,进行多因素Logistics回归分析并构建预测模型.从全基因组关联研究(GWAS)公开数据库中获取OSAHS和OME的数据,进行双样本孟德尔随机化(Mendelian randomization,MR)分析.结果 儿童OSAHS患者发生OME的风险预测模型,Hosmer-Lemeshow拟合优度检验(χ2=12.541,P=0.157),C指数为0.749,Calibration校准曲线拟合效果较好,表明儿童OSAHS和OME具有相关性.此外,MR分析使用逆方差加权方法,观察到儿童OSAHS和OME之间存在正向因果关系(OR=1.05,95%CI=0.999~1.051,P=0.005).MR-Egger检测结果(Q=42.358,P=0.716)和IVW(Q=43.271,P=0.759)显示分析不存在异质性,MR-Egger截距(截距=-0.004,P=0.921)分析显示不存在水平多效性,MR分析结果稳定.结论 儿童OSAHS和OME存在一定的相关性,并且儿童OSAHS会增加OME的风险.
OBJECTIVE To explore the correlation between childhood obstructive sleep apnea hypopnea syndrome and otitis media with effusion,to provide evidence-based basis for clinical diagnosis and treatment.METHODS A total of 985 children were diagnosed in the Department of Otolaryngology,Heping Hospital Affiliated to Changzhi Medical College from September 2019 to March 2025.Combined or no OME patients for multivariate logistics regression analysis and construct related risk prediction model,obtain data of OSAHS(exposure factors)and OME(outcome)from the public database of genome-wide association studies(GWAS),two-sample Mendelian randomization(MR)analysis.RESULTS The risk prediction model for OME in children with OSAHS,Hosmer-Lemeshow goodness of fit test(χ2=12.541,P=0.157),C index of 0.749,Calibration calibration curve fitting,and correlation between children OSHAS and OME.Furthermore,the MR analysis using inverse variance weighting observed a positive causal relationship between OSAHS and OME in children(OR=1.05,95%CI=0.999-1.051,P=0.005).MR Egger test results(Q=42.358,P=0.716)and IVW(Q=43.271,P=0.759)showed no heterogeneity in the analysis,MR Egger intercept(intercept=-0.004,P=0.921)showed no horizontal pleiotropy,and the MR analysis results were stable.CONCLUSION There is a correlation between pediatric OSAHS and OME,and it increases the risk of OME.
赵亚会;郭建宙;常玮;邱招凤;刘宇
长治医学院附属和平医院耳鼻咽喉科,山西 长治 046000长治医学院附属和平医院耳鼻咽喉科,山西 长治 046000长治医学院附属和平医院耳鼻咽喉科,山西 长治 046000长治医学院附属和平医院耳鼻咽喉科,山西 长治 046000长治医学院附属和平医院耳鼻咽喉科,山西 长治 046000
儿童睡眠呼吸暂停,阻塞性分泌性中耳炎预测模型孟德尔随机化
ChildSleep Apnea,Obstructiveotitis media with effusionpredictive modelMendelian randomization
《中国耳鼻咽喉头颈外科》 2025 (6)
381-385,5
2019年长治医学院附属和平医院院级项目(2019141)
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