中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
22期
1705-1708
,共4页
肺炎旁胸腔积液%纤维分隔%相关因素%Logistic回归分析%儿童
肺炎徬胸腔積液%纖維分隔%相關因素%Logistic迴歸分析%兒童
폐염방흉강적액%섬유분격%상관인소%Logistic회귀분석%인동
Parapneumonic pleural effusion%Loculation%Relevant factors%Logistic regression analysis%Child
目的 探讨儿童肺炎旁胸腔积液(PPE)发生纤维分隔的相关因素.方法 收集2012年1月至2015年3月河北省儿童医院住院的172例PPE患儿,根据胸部B超检查结果分为纤维分隔组(78例)和无纤维分隔组(94例).记录2组患儿的性别、年龄、入院前病程、热程、胸腔积液发生部位,外周血白细胞(WBC)、中性粒细胞比例(N)、血小板(PLT)、乳酸脱氢酶(LDH)、C反应蛋白(CRP)、支原体(MP),胸腔积液中WBC(WBCp)、多核细胞比例(PMN)、乳酸脱氢酶(LDHp)、葡萄糖(GLU)、腺苷脱氨酶(ADA)、乳酸(LAC)、CRP(CRPp).对2组上述各项指标进行组间对照,先行单因素分析,对单因素分析结果中P＜0.01的指标进一步行多因素Logistic回归分析,并绘制受试者工作特征(ROC)曲线,评价Logistic回归模型的预测能力.结果 1.单因素分析结果显示月龄、WBC、PLT、LDH、是否MP感染及WBCp、PMN、GLU、LAC共9个因素,差异有统计学意义(P均＜0.05).2.多因素Logistic回归分析显示,PLT、LAC、LDH、GLU、MP感染是PPE纤维分隔形成的危险因素(OR=3.437,P=0.007;OR =3.656,P=0.003;OR=0.306,P=0.006;OR =0.324,P=0.037;OR=0.375,P=0.022).3.ROC曲线下面积为0.876,P=0.000,该回归模型有中等偏上诊断准确度.结论 外周血PLT ＞434.5×109/L、LDH ＜400 U/L、非MP感染、胸腔积液GLU＜ 6.11 mmol/L、LAC＞ 3.83 mmol/L时,PPE患儿发生纤维分隔的可能性较大.
目的 探討兒童肺炎徬胸腔積液(PPE)髮生纖維分隔的相關因素.方法 收集2012年1月至2015年3月河北省兒童醫院住院的172例PPE患兒,根據胸部B超檢查結果分為纖維分隔組(78例)和無纖維分隔組(94例).記錄2組患兒的性彆、年齡、入院前病程、熱程、胸腔積液髮生部位,外週血白細胞(WBC)、中性粒細胞比例(N)、血小闆(PLT)、乳痠脫氫酶(LDH)、C反應蛋白(CRP)、支原體(MP),胸腔積液中WBC(WBCp)、多覈細胞比例(PMN)、乳痠脫氫酶(LDHp)、葡萄糖(GLU)、腺苷脫氨酶(ADA)、乳痠(LAC)、CRP(CRPp).對2組上述各項指標進行組間對照,先行單因素分析,對單因素分析結果中P＜0.01的指標進一步行多因素Logistic迴歸分析,併繪製受試者工作特徵(ROC)麯線,評價Logistic迴歸模型的預測能力.結果 1.單因素分析結果顯示月齡、WBC、PLT、LDH、是否MP感染及WBCp、PMN、GLU、LAC共9箇因素,差異有統計學意義(P均＜0.05).2.多因素Logistic迴歸分析顯示,PLT、LAC、LDH、GLU、MP感染是PPE纖維分隔形成的危險因素(OR=3.437,P=0.007;OR =3.656,P=0.003;OR=0.306,P=0.006;OR =0.324,P=0.037;OR=0.375,P=0.022).3.ROC麯線下麵積為0.876,P=0.000,該迴歸模型有中等偏上診斷準確度.結論 外週血PLT ＞434.5×109/L、LDH ＜400 U/L、非MP感染、胸腔積液GLU＜ 6.11 mmol/L、LAC＞ 3.83 mmol/L時,PPE患兒髮生纖維分隔的可能性較大.
목적 탐토인동폐염방흉강적액(PPE)발생섬유분격적상관인소.방법 수집2012년1월지2015년3월하북성인동의원주원적172례PPE환인,근거흉부B초검사결과분위섬유분격조(78례)화무섬유분격조(94례).기록2조환인적성별、년령、입원전병정、열정、흉강적액발생부위,외주혈백세포(WBC)、중성립세포비례(N)、혈소판(PLT)、유산탈경매(LDH)、C반응단백(CRP)、지원체(MP),흉강적액중WBC(WBCp)、다핵세포비례(PMN)、유산탈경매(LDHp)、포도당(GLU)、선감탈안매(ADA)、유산(LAC)、CRP(CRPp).대2조상술각항지표진행조간대조,선행단인소분석,대단인소분석결과중P＜0.01적지표진일보행다인소Logistic회귀분석,병회제수시자공작특정(ROC)곡선,평개Logistic회귀모형적예측능력.결과 1.단인소분석결과현시월령、WBC、PLT、LDH、시부MP감염급WBCp、PMN、GLU、LAC공9개인소,차이유통계학의의(P균＜0.05).2.다인소Logistic회귀분석현시,PLT、LAC、LDH、GLU、MP감염시PPE섬유분격형성적위험인소(OR=3.437,P=0.007;OR =3.656,P=0.003;OR=0.306,P=0.006;OR =0.324,P=0.037;OR=0.375,P=0.022).3.ROC곡선하면적위0.876,P=0.000,해회귀모형유중등편상진단준학도.결론 외주혈PLT ＞434.5×109/L、LDH ＜400 U/L、비MP감염、흉강적액GLU＜ 6.11 mmol/L、LAC＞ 3.83 mmol/L시,PPE환인발생섬유분격적가능성교대.
Objective To identify the relevant factors for the loculation clinically in children with parapneumonic pleural effusion (PPE).Methods The clinical data of 172 children with PPE were retrospectively reviewed from January 2012 to March 2015 in Children's Hospital of Hebei Province.Based on the findings of chest ultrasound, the subjects were divided into 2 groups, the loculation group (78 cases) and the control group (94 cases).The comparison was made between the 2 groups in gender, age, course of disease and fever before admitting into hospital, the location of the effusion, white blood cells (WBC) and the percentage of neutrophils (N), blood platelet (PLT) ,lactate dehydrogenase (LDH),C-reactive protein (CRP), mycoplasma (MP), the routine and biochemical examination of pleural fluid, including white cell count (WBCp), the percentage of polymorphonuclear cell (PMN), lactate dehydrogenase (LDHp) ,glucose (GLU) ,adenosine deaminase (ADA) ,lactic acid (LAC) and C-reactive protein (CRPp).If the result of single factor regression showed P ＜ 0.01, the indicators were analyzed by the multifactor Logistic regression.The receiver operator characteristic (ROC) curve was drawn to evaluate the prediction ability of Logistic regression models.Results (1) The result of single factor regression indicated that the risk factors included age, WBC, PLT, LDH, MP, WBCp, PMN, GLU and LAC (all P ＜ 0.05).(2) The result of multifactor Logistic regression showed that the factors included PLT (OR =3.437,P =0.007), LDH (OR =0.306, P =0.006), GLU (OR =0.324, P =0.037), MP (OR =0.375 ,P =0.022) and LAC (OR =3.656, P =0.003).(3) The area under the ROC curve was 0.876, P =0.000,which indicated that the regression models had over medium diagnostic accuracy.Conclusions When PLT ＞ 434.5 × 109/L,LDH ＜400 U/L,non MP infection,GLU ＜6.11 mmol/L and LAC ＞3.83 mmol/L,it may indicate that the formation of loculation for the PPE children.
