中国中医药信息杂志2026，Vol.33Issue(5)：117-122,6.DOI:10.19879/j.cnki.1005-5304.202510370
基于中医证型及临床指标构建儿童肺炎支原体肺炎发展为重症的预测模型
Construction of a Predictive Model for Mycoplasma pneumoniae Pneumonia in Children Developing into Severe MPP Based on TCM Syndromes and Clinical Indicators
摘要
Abstract
Objective To analyze the risk factors for Mycoplasma pneumoniae pneumonia(MPP)in children developing into severe MPP(SMPP);To construct a nomogram prediction model.Methods A retrospective cohort study was conducted.The TCM syndromes and clinical data of children with MPP diagnosed for the first time in the pediatric outpatient department of Traditional Chinese Medicine of Shunyi Maternal and Children's Hospital of Beijing Children's Hospital from January 1st 2024 to December 31st 2024 were included.According to whether they eventually developed into SMPP,they were divided into general group and severe group.Totally 13 indicators including gender,age,TCM syndrome type,cough days,fever days,high fever days,neutral cell count,CRP,SAA,chest X-ray score were compared between the two groups.The meaningful indicators of univariate analysis were included in binary Logistic regression for multivariate analysis to identify independent risk factors and construct a nomogram prediction model.Receiver operating characteristic curve,calibration curve,Hosmer-Lemeshow goodness of fit test,and decision curve analysis were used to evaluate the nomogram.Results A total of 307 cases were included,including 222 cases in the general group and 85 cases in the severe group.TCM syndrome type of phlegm-heat obstructing lung syndrome(aOR=3.246,95%CI:1.018-10.355,P=0.047),high fever days(aOR=2.362,95%CI:1.641-3.402,P<0.001),chest X-ray score(aOR=1.657,95%CI:1.288-2.132,P<0.001)and CRP(aOR=1.064,95%CI:1.012-1.118,P=0.015)were independent risk factors for MPP to develop into SMPP,while cough days(aOR=0.618,95%CI:0.461-0.828,P<0.001)showed a protective effect.The nomogram prediction model constructed based on the above five indicators had a good discriminant ability,calibration and clinical practicability after internal verification.Conclusion TCM syndrome type(phlegm-heat obstructing lung syndrome),high fever days,chest X-ray score and CRP are independent risk factors for the development of MPP into SMPP,and the number of cough days is a protective factor.The nomogram prediction model constructed on this basis is helpful for clinicians to identify high-risk children early,so as to achieve accurate treatment.关键词
中医证型/临床指标/肺炎支原体肺炎/重症肺炎支原体肺炎/预测模型Key words
TCM syndrome type/clinical index/Mycoplasma pneumoniae pneumonia/severe MPP/prediction model分类
医药卫生引用本文复制引用
申慧贞,王俊宏,郝静,赵骞,李旭峰,赵磊..基于中医证型及临床指标构建儿童肺炎支原体肺炎发展为重症的预测模型[J].中国中医药信息杂志,2026,33(5):117-122,6.基金项目
首都卫生发展科研专项(首发2024-2-2096) （首发2024-2-2096）
