郑州大学学报（医学版）2026，Vol.61Issue(2)：123-127,5.DOI:10.13705/j.issn.1671-6825.2025.03.065
大叶性肺炎合并肺炎支原体感染患儿继发气道高反应预测模型的构建
Development of a predictive model for secondary airway hyperresponsive-ness in children with lobar pneumonia complicated by Mycoplasma pneu-moniae infection
摘要
Abstract
Aim:To develop a predictive model for secondary airway hyperresponsiveness(AHR)in children with lobar pneumonia complicated by Mycoplasma pneumoniae(MP)infection.Methods:A total of 125 children with lobar pneumonia complicated by MP infection who were treated at Anhui No.2 Provincial People′s Hospital from January 2021 to December 2023 were selected as the study subjects.The patients were divided into an AHR group and a non-AHR group based on whether AHR occurred during hospitalization.Clinical data and laboratory indicators were collected for both groups.Logistic regression analysis was used to identify the influencing factors for AHR.Based on the identified factors,a nomogram model was constructed using R software.The predictive performance of the model was evaluated using the receiver operating char-acteristic(ROC)curve.Bootstrap resampling(1 000 iterations)was used for internal validation.Calibration curves were plotted,and model consistency was assessed using the Hosmer-Lemeshow test.The clinical utility of the model was evaluated using decision curve analysis(DCA).Results:Among the 125 children,25(20.00％)developed secondary AHR.Fever duration≥7 days,antibiotic use>7 days,C-reactive protein(CRP),and lactate dehydrogenase(LDH)were identified as influencing factors for secondary AHR(P<0.05).The nomogram model constructed based on these factors achieved an are-a under the ROC curve(AUC)(95％CI)of 0.872(0.638-0.984),with a sensitivity of 0.963 and a specificity of 0.768(P<0.001).The C-index(95％CI)after Bootstrap validation was 0.835(0.786-0.991).The predicted probabilities were close to the actual observed probabilities,and the Hosmer Lemeshow goodness of fit test yielded χ2=1.837(P=0.738).The nomogram model demonstrated a higher net benefit within the risk threshold range of 0％-80％.Conclusion:The constructed nomogram model has high predictive value for secondary AHR in children with lobar pneumonia complicat-ed by MP infection.关键词
大叶性肺炎/肺炎支原体感染/气道高反应/Logistic 回归/列线图模型Key words
lobar pneumonia/Mycoplasma pneumoniae infection/airway hyperresponsiveness/Logistic regression/no-mogram model分类
医药卫生引用本文复制引用
陈群梅,郭齐,江生周..大叶性肺炎合并肺炎支原体感染患儿继发气道高反应预测模型的构建[J].郑州大学学报（医学版）,2026,61(2):123-127,5.基金项目
安徽省高等学校科学研究项目(2023AH053378) （2023AH053378）
