湖北科技学院学报（医学版）2026，Vol.40Issue(4)：349-355,7.DOI:10.16751/j.cnki.2095-4646.2026030513
个体化预测过敏性紫癜儿童社交退缩的列线图模型建立
Establishment of a Nomogram Model for Individualized Prediction of Social Withdrawal in Children with Allergic Purpura
摘要
Abstract
Objective To investigate the risk factors associated with social withdrawal in children with Henoch-Schönlein purpura(HSP)and to construct an individualized predictive nomogram model.Methods A total of 200 pediatric patients with HSP admitted to our hospital were enrolled in this study.They were divided into a social withdrawal group(68 cases)and a non-withdrawal group(132 cases)based on the Achenbach's Child Behavior Scale(CBCL)evaluation results.Multidimensional data-including demographics,disease charac-teristics,psychological and behavioral profiles,and family environment-were collected.Univariate and multivariate logistic regression analyses were employed to identify independent influencing factors,which were then used to construct a nomogram prediction model.The model's dis-crimination,calibration,and clinical utility were validated using receiver operating characteristic(ROC)curves,calibration curves,and deci-sion curve analysis(DCA).Results Multivariate logistic regression analysis showed that symptom score(OR=1.309,95%CI=1.097～1.563),number of purpura recurrences(OR=2.783,95%CI=1.504～5.151),Children's Sleep Habits Questionnaire(CSHQ-CH-R)score(OR=1.049,95%CI=1.018～1.080),Spence Children's Anxiety Scale(SCAS)score(OR=1.060,95%CI=1.023～1.098),Parental Maximum Depression-Anxia-Stress Scale(DASS-21)score(OR=1.065,95%CI=1.013～1.121),and maternal overprotection(assessed by the Short-form Egna Minnen Beträffande Uppfostran for Children,S-EMBU-C;OR=1.198,95%CI:1.079～1.331)were in-dependent risk factors for social withdrawal in children with HSP,whereas maternal emotional warmth(S-EMBU-C;OR=0.840,95%CI:0.763～0.924)was a protective factor(all P<0.05).The nomogram model constructed using the aforementioned factors had an area un-der the ROC curve(AUC)of 0.878(95%CI:0.827～0.928),and the calibration curve showed good fit with the reference line(Hosmer-Lemeshow test,χ2=6.144,P=0.631),and the pick curve indicated a clinical net gain within the threshold probability range of 0.15～0.55.Conclusion The nomogram model successfully developed in this study effectively integrates disease severity,psychological status,and family parenting factors in children with HSP,enabling individualized prediction of the risk of social withdrawal,offering a visual tool for the early clinical identification of high-risk children and for the performance of focused psychological nursing intervention.关键词
过敏性紫癜/儿童/社交退缩/列线图/预测模型/心理护理Key words
Henoch-Schonlein Purpura/Children/Social withdrawal/Nomogram/Predictive model/Psychological care分类
医药卫生引用本文复制引用
王漫漫,刘继秀..个体化预测过敏性紫癜儿童社交退缩的列线图模型建立[J].湖北科技学院学报（医学版）,2026,40(4):349-355,7.基金项目
2025年度蚌埠市智库建设及社科规划项目(BB25B1070) （BB25B1070）
