实用医学杂志2025，Vol.41Issue(15)：2342-2348,7.DOI:10.3969/j.issn.1006-5725.2025.15.008
大理高海拔地区早产儿呼吸窘迫综合征发生风险的列线图预测模型构建
Construction of risk prediction model for preterm infant respiratory distress syndrome in Dali Prefecture
摘要
Abstract
Objective To develop a nomogram-based predictive model for assessing the risk of respiratory distress syndrome(RDS)in premature infants in the high-altitude region of Dali.The predictive performance and clinical applicability of the model will be systematically evaluated to provide evidence-based guidance for the early diagnosis and clinical management of respiratory distress in premature infants.Methods A total of 680 preterm infants admitted to the Dali Maternal and Child Health Hospital between January 2020 and December 2024 were enrolled in the study and randomly divided into a training set(n=476)and a validation set(n=204)at a ratio of 7∶3.Independent predictors were identified through univariate logistic regression and multivariate stepwise regression analyses,and a nomogram model was subsequently developed using R software.The performance of the model,including its discrimination,calibration,stability,and clinical applicability,was evaluated using the receiver operating characteristic curve(ROC),Hosmer-Lemeshow goodness-of-fit test,bootstrap resampling method,and decision curve analysis(DCA).Results The final model incorporated seven independent variables:gestational age,birth weight,Apgar score,blood oxygen saturation,gestational hyperglycemia,prenatal glucocor-ticoid therapy,and maternal history of infection.The areas under the curve(AUCs)for the training and validation sets were 0.88(95%CI:0.84～0.92)and 0.83(95%CI:0.76～0.89),respectively,with all Hosmer-Lemeshow test p-values exceeding 0.05.The bootstrap-corrected AUC was 0.85(95%CI:0.81～0.89).DCA indicated that the model achieved the highest net benefit at a risk threshold range of 10%to 35%.Conclusions This model integrates multiple risk factors associated with the occurrence of RDS in plateau environments,demonstrating robust predictive performance for RDS in preterm infants residing in high-altitude areas such as Dali.It can serve as a valuable tool for risk stratification and clinical decision-making,and may also provide a reference for future multicenter prospective studies.关键词
早产儿/呼吸窘迫综合征/列线图/高海拔地区/多因素logistic回归/预测模型Key words
preterm infants/respiratory distress syndrome/nomogram/high-altitude areas/multi-variate logistic regression/prediction model分类
医药卫生引用本文复制引用
张红,章容,杨鹏程,罗丽艳,张文龙,成玉蓉,刘文琳,董文斌..大理高海拔地区早产儿呼吸窘迫综合征发生风险的列线图预测模型构建[J].实用医学杂志,2025,41(15):2342-2348,7.基金项目
国家自然科学基金项目(编号:82371710) （编号:82371710）
