临床输血与检验2025，Vol.27Issue(6)：802-809,8.DOI:10.3969/j.issn.1671-2587.2025.06.009
ABO胎儿新生儿溶血病并发重度高胆红素血症风险预测模型研究
Exploring the Risk Prediction Model of ABO Hemolytic Disease of the Fetus and Newborn Complicated with Severe Hyperbilirubinemia
摘要
Abstract
Objective To construct and validate a prediction model for severe hyperbilirubinemia complicating ABO hemolytic disease of the fetus and newborn(ABO-HDNF),providing a basis for timely clinical intervention.Methods We retrospectively analyzed clinical data from 306 ABO-HDNF infants diagnosed and treated between January 2022 and December 2024.Of these,204 cases were regarded as the modeling set and 102 the validation set.Patients were stratified into severe and non-severe hyperbilirubinemia groups.Risk factors for severe hyperbilirubinemia were identified through univariate analysis and binary logistic regression.A nomogram model was constructed,with receiver operating characteristic(ROC)and calibration curves evaluating its performance.Clinical utility of the model was further evaluated using a clinical decision curve.Results Univariate and binary logistic regression analyses identified postnatal time at admission(OR=1.303),positive Direct Antiglobulin Test(OR=3.073),eluate agglutination strength(OR=3.189),and total bilirubin/albumin ratio(OR=1.863)as independent risk factors for severe hyperbilirubinemia(P＜0.05).The nomogram demonstrated a C-index of 0.790(95％CI:0.713～0.867).Area under the curve(AUC)values were 0.790(95％CI:0.713～0.867)and 0.754(95％CI:0.638～0.871)for modeling and validation sets,respectively.Calibration curves indicated good consistency,and decision curve analysis showed high net clinical benefit.Conclusion The nomogram incorporating postnatal time,Direct Antiglobulin Test results,eluate agglutination strength,and total bilirubin/albumin ratio exhibits favorable predictive performance for severe hyperbilirubinemia complicating ABO-HDNF.关键词
ABO胎儿新生儿溶血病/重度高胆红素血症/预测模型/列线图Key words
ABO hemolytic disease of the fetus and newborn/Severe hyperbilirubinemia/Predictive model/Nomogram分类
医药卫生引用本文复制引用
沈倩云,吴德群,张明,程文国,陈剑..ABO胎儿新生儿溶血病并发重度高胆红素血症风险预测模型研究[J].临床输血与检验,2025,27(6):802-809,8.基金项目
本课题受扬州市重点研发计划(社会发展)项目(No.YZ2024134)资助 （社会发展）
