Analysis of influencing factors of recurrent wheezing in children with bronchopneumonia and construction of prediction model

doi:10.11958/20231879

Abstract

Abstract:

Objective To explore clinical influencing factors of recurrent wheezing in children with bronchopneumonia, and construct a risk prediction model. Methods A total of 155 children with bronchopneumonia were divided into the recurrent wheezing group (47 cases) and the non-recurrent wheezing group (108 cases) according to the occurrence of recurrent wheezing within 1 year after discharge. General clinical data, including the length of hospital stay, total course of disease, history of eczema, history of other personal allergies (food allergy history, drug allergy history, allergic rhinitis history and allergic dermatitis history), family history of allergies, living environment, frequency of colds and exposure to allergens, and laboratory indexes [T lymphocyte subsets, eosinophils (EOS), 25-hydroxy vitamin D3 and total immunoglobulin E (IgE)] were compared between the 2 groups. Multivariate Logistic regression analysis was conducted to identify influencing factors of recurrent wheezing, and a risk prediction model was constructed. Homser-Lemeshow tested the goodness of fit of the model. The predictive performance of the model was evaluated using the receiver operating characteristic (ROC) curve. Results Compared with the non-recurrent wheezing group, the proportions of children with history of other personal allergies, EOS positivity (>9%), vitamin D insufficiency (<30 μg/L) and total IgE positivity (>60 IU/mL) were higher in the recurrent wheezing group (P<0.05). Multivariate Logistic regression analysis showed that history of personal allergies, EOS positive, vitamin D insufficiency and total IgE positive were independent risk factors for recurrent wheezing in children with bronchopneumonia (P<0.05). Homser-Lemeshow showed that prediction model had goodness of fit (χ²=3.055, P=0.692). The model predicted that the area under curve for recurrent wheezing was 0.816, sensitivity and specificity of the model for predicting recurrent wheezing were 70.21% and 80.56%, respectively. Conclusion The prediction model constructed based on history of personal allergies, EOS positive, vitamin D insufficiency and total IgE positive has good predictive performance for recurrent wheezing in children.

Key words: bronchopneumonia, influencing factor analysis, diagnosis, identification, risk factor, recurrent wheezing

CLC Number:

R725.6

Figures/Tables 5

References 18

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组别	n	性别（男/女）	年龄/月	分娩方式
组别	n	性别（男/女）	年龄/月	剖宫产	自然分娩
非反复喘息组	108	55/53	38.47±15.21	46（42.59）	62（57.41）
反复喘息组	47	31/16	36.70±15.07	22（46.81）	25（53.19）
χ²或t		2.996	0.668	0.236
组别		早产史	低出生体质量	喂养方式
组别		早产史	低出生体质量	纯母乳	非纯母乳
非反复喘息组		3（2.78）	4（3.70）	29（26.85）	79（73.15）
反复喘息组		1（2.13）	2（4.26）	10（21.28）	37（78.72）
χ²或P		1.000^▲	1.000^▲	0.541

组别	n	性别（男/女）	年龄/月	分娩方式
组别	n	性别（男/女）	年龄/月	剖宫产	自然分娩
非反复喘息组	108	55/53	38.47±15.21	46（42.59）	62（57.41）
反复喘息组	47	31/16	36.70±15.07	22（46.81）	25（53.19）
χ²或t		2.996	0.668	0.236
组别		早产史	低出生体质量	喂养方式
组别		早产史	低出生体质量	纯母乳	非纯母乳
非反复喘息组		3（2.78）	4（3.70）	29（26.85）	79（73.15）
反复喘息组		1（2.13）	2（4.26）	10（21.28）	37（78.72）
χ²或P		1.000^▲	1.000^▲	0.541

组别	n		住院时间/d		总病程/d		湿疹史	个人过敏史
非反复喘息组	108		7.72±1.86		14.79±3.65		25（23.15）	26（24.07）
反复喘息组	47		8.28±2.02		15.81±3.27		17（36.17）	22（46.81）
χ²或t			1.660		1.650		2.811	7.918^＊＊
组别		生活环境				感冒次数/次			变应原暴露
组别		农村		城市		感冒次数/次			变应原暴露
非反复喘息组		69（63.89）		39（36.11）		3.50（2.00，5.00）			20（18.52）
反复喘息组		27（57.45）		20（42.55）		4.00（2.00，6.00）			15（31.91）
χ²或Z		0.576				1.007			3.362

组别	n		住院时间/d		总病程/d		湿疹史	个人过敏史
非反复喘息组	108		7.72±1.86		14.79±3.65		25（23.15）	26（24.07）
反复喘息组	47		8.28±2.02		15.81±3.27		17（36.17）	22（46.81）
χ²或t			1.660		1.650		2.811	7.918^＊＊
组别		生活环境				感冒次数/次			变应原暴露
组别		农村		城市		感冒次数/次			变应原暴露
非反复喘息组		69（63.89）		39（36.11）		3.50（2.00，5.00）			20（18.52）
反复喘息组		27（57.45）		20（42.55）		4.00（2.00，6.00）			15（31.91）
χ²或Z		0.576				1.007			3.362

组别	n	CD3⁺/ %	CD3⁺CD4⁺/ %	CD3⁺CD8⁺/ %	CD3⁺CD4⁺/ CD3⁺CD8⁺
非反复喘息组	108	61.71±10.57	35.28±8.32	23.61±5.53	1.59±0.59
反复喘息组	47	63.89±13.98	37.17±8.32	25.02±4.21	1.53±0.45
t		1.067	1.301	1.735	0.597
组别		EOS阳性		维生素D不足	总IgE阳性
非反复喘息组		7（6.48）		8（7.41）	18（16.67）
反复喘息组		12（25.53）		13（27.66）	20（42.55）
χ²		11.050^＊＊		11.468^＊＊	11.859^＊＊