中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2015年
6期
414-418
,共5页
张碧丽%刘涛%林书祥%王文红%刘妍%刘艳%吴瑕%王欣%刘喆
張碧麗%劉濤%林書祥%王文紅%劉妍%劉豔%吳瑕%王訢%劉喆
장벽려%류도%림서상%왕문홍%류연%류염%오하%왕흔%류철
肾病综合征,原发性%抗药性,激素%儿童%预测
腎病綜閤徵,原髮性%抗藥性,激素%兒童%預測
신병종합정,원발성%항약성,격소%인동%예측
Nephrotic syndrome,primary%Drugs resistance,steroid%Children%Predict
目的 寻找原发性肾病综合征(PNS)患儿发生激素耐药的危险因素,建立预测激素耐药的积分法模型.方法 病例来自2011年10月至2013年10月在天津市儿童医院肾内科住院的初发PNS患儿185例.收集患儿临床指标、实验室检查及影像学检查等资料.采用单因素相关分析、受试者工作特征曲线(ROC)及logistic回归分析方法筛选PNS发生激素耐药的危险因素,进而对危险因素进行积分,初步建立预测激素耐药的模型,并对模型的预测作用进行检验.结果 (1)单因素分析、ROC曲线及logistic回归分析结果提示,PNS患儿年龄≥6.5岁(X1)、镜下血尿(X2)和尿蛋白量≥177.49 mg· kg-1·d-1(X3)是发生激素耐药的高危因素,logistic回归预测模型为Y=6.761-2.947X1-3.336X2-2.669X3.(2)回归模型的拟合效果分析结果提示:根据预测模型分别计算激素敏感型肾病综合征(SSNS)组及激素耐药型肾病综合征(SRNS)组患儿所得分值,绘制ROC曲线得出,当危险因素总分值≤0.95时,诊断的灵敏度为56.56%、特异度为96.62%,ROC曲线下面积为0.86(P< 0.05).结论 年龄≥6.5岁,镜下血尿及尿蛋白量≥177.49 mg· kg-1·d-1为PNS患儿发生激素耐药的危险因素.
目的 尋找原髮性腎病綜閤徵(PNS)患兒髮生激素耐藥的危險因素,建立預測激素耐藥的積分法模型.方法 病例來自2011年10月至2013年10月在天津市兒童醫院腎內科住院的初髮PNS患兒185例.收集患兒臨床指標、實驗室檢查及影像學檢查等資料.採用單因素相關分析、受試者工作特徵麯線(ROC)及logistic迴歸分析方法篩選PNS髮生激素耐藥的危險因素,進而對危險因素進行積分,初步建立預測激素耐藥的模型,併對模型的預測作用進行檢驗.結果 (1)單因素分析、ROC麯線及logistic迴歸分析結果提示,PNS患兒年齡≥6.5歲(X1)、鏡下血尿(X2)和尿蛋白量≥177.49 mg· kg-1·d-1(X3)是髮生激素耐藥的高危因素,logistic迴歸預測模型為Y=6.761-2.947X1-3.336X2-2.669X3.(2)迴歸模型的擬閤效果分析結果提示:根據預測模型分彆計算激素敏感型腎病綜閤徵(SSNS)組及激素耐藥型腎病綜閤徵(SRNS)組患兒所得分值,繪製ROC麯線得齣,噹危險因素總分值≤0.95時,診斷的靈敏度為56.56%、特異度為96.62%,ROC麯線下麵積為0.86(P< 0.05).結論 年齡≥6.5歲,鏡下血尿及尿蛋白量≥177.49 mg· kg-1·d-1為PNS患兒髮生激素耐藥的危險因素.
목적 심조원발성신병종합정(PNS)환인발생격소내약적위험인소,건립예측격소내약적적분법모형.방법 병례래자2011년10월지2013년10월재천진시인동의원신내과주원적초발PNS환인185례.수집환인림상지표、실험실검사급영상학검사등자료.채용단인소상관분석、수시자공작특정곡선(ROC)급logistic회귀분석방법사선PNS발생격소내약적위험인소,진이대위험인소진행적분,초보건립예측격소내약적모형,병대모형적예측작용진행검험.결과 (1)단인소분석、ROC곡선급logistic회귀분석결과제시,PNS환인년령≥6.5세(X1)、경하혈뇨(X2)화뇨단백량≥177.49 mg· kg-1·d-1(X3)시발생격소내약적고위인소,logistic회귀예측모형위Y=6.761-2.947X1-3.336X2-2.669X3.(2)회귀모형적의합효과분석결과제시:근거예측모형분별계산격소민감형신병종합정(SSNS)조급격소내약형신병종합정(SRNS)조환인소득분치,회제ROC곡선득출,당위험인소총분치≤0.95시,진단적령민도위56.56%、특이도위96.62%,ROC곡선하면적위0.86(P< 0.05).결론 년령≥6.5세,경하혈뇨급뇨단백량≥177.49 mg· kg-1·d-1위PNS환인발생격소내약적위험인소.
Objective To seek the risk factors of steroid resistance in children with primary nephritic syndrome,and construct the predicting model of steroid resistance.Methods The clinical indicators of 185 patients with primary nephrotic syndrome (PNS) were collected,including clinical data,laboratory and imaging examination.The risk factors of steroid resistance were found using single factor analysis,receiver operator characteristic (ROC) and logistic regression test.The predicting model of steroid resistance was constructed based on integral method model.Results The results of single factor analysis,receiver operating characteristic curve (ROC) and logistic regression analysis showed that the age more than 6.5 years old,having microscopic hematuria and the 24 h urine protein content (24 hUP) more than 177.49 mg· kg-1 · d-1 were the significant risk factors of steroid resistant nephrotic syndrome (SRNS).Logistic regression prediction model was Y=6.761-2.947X1-3.336X2-2.669X3.The result of receiver operator characteristic showed that when the score was 0.95,the sensitivity and specificity was 56.56%,96.62% respectively and the area under ROC was 0.86,P<0.05).Conclusions The age more than 6.5 years old,having microscopic hematuria and 24 h urine protein content more than 177.49 mg· kg-1· d-1 are the significant risk factors of SRNS.