国际神经病学神经外科学杂志2025，Vol.52Issue(6)：33-41,9.DOI:10.16636/j.cnki.jinn.1673-2642.2025.06.005
儿童化脓性脑膜脑炎并发癫痫的危险因素分析及列线图预测模型构建与验证
Risk factors for epilepsy in children with purulent meningitis and establishment and validation of a nomogram prediction model
摘要
Abstract
Objective To investigate the risk factors for epilepsy in children with purulent meningitis,and to establish and validate a nomogram prediction model.Methods A retrospective analysis was performed for 486 children with purulent meningitis who were admitted to Nanyang Central Hospital from January 2020 to June 2024.Aaccording to the presence or absence of epilepsy,they were divided into epilepsy group with 89 children and non-epilepsy group with 397 children.Related data were collected and compared between the two groups.A multivariate logistic regression analysis was used to investigate the risk factors for epilepsy,and a nomogram prediction model was established based on these risk factors.Results For the 486 children,the incidence rate of epilepsy was 18.3%(89/486),among whom 28(31.5%)had early-onset epilepsy and 61(68.5%)had late-onset epilepsy.Generalized tonic-clonic seizure was the main type of seizure.The multivariate logistic regression analysis showed that age,pneumococcal infection,cerebrospinal fluid protein levels,neuron specific enolase,S100β protein,brain parenchymal lesions,and epilepsy-like or special patterns on electroencephalography were risk factors for the onset of epilepsy.The nomogram model established based on the above factors had an area under the curve of 0.891 for predicting the onset of epilepsy,with the optimal cut-off value of 142 points.Bootstrap internal validation showed that the model had good calibration.According to the total score of the nomogram,the children were divided into low-risk,medium-risk,and high-risk groups,and the incidence rates of epilepsy were 3.8%,19.4%,and 63.8%,respectively(P<0.001),suggesting that the model had good discriminatory ability.Conclusions The nomogram prediction model established based on the risk factors has good discriminatory ability and calibration and can provide a reliable tool for early identification of children with purulent meningitis at a high risk of epilepsy in clinical practice.关键词
化脓性脑膜脑炎/癫痫/危险因素/列线图/预测模型/儿童Key words
bacterial meningitis/epilepsy/risk factors/nomogram/prediction model/children分类
医药卫生引用本文复制引用
曾苑,贾晓丹,宋哲..儿童化脓性脑膜脑炎并发癫痫的危险因素分析及列线图预测模型构建与验证[J].国际神经病学神经外科学杂志,2025,52(6):33-41,9.基金项目
河南省青年科学基金(20230047). （20230047）
