| 摘要: |
| ［摘要］ 目的 构建手足口病合并早期神经系统受累的临床预测规则（CPR）。方法 收集2014-01～2017-02郑州市儿童医院感染科诊治的手足口病患儿1 132例，使用R 3.4.4软件进行所有数据的分析处理，筛选相应预测变量构建CPR，并使用ROC曲线和校准曲线对其性能进行评价。结果 所有纳入患儿根据是否合并中枢神经系统（CNS）受累分为轻症组695例和CNS损害组437例。最终构建的CPR包括4个独立危险因素：体温≥38.5 ℃，发热时间≥3 d，白细胞≥10.8×109/L，年龄<1岁（或2～3岁）。诊断性ROC曲线下面积为0.821，敏感度为89.2%，特异度为80.7%，最佳临界值为4分。结论 构建的CPR具有简单、实用和直观等优势，对后续研究及临床实践具有一定的参考价值。 |
| 关键词: 重症手足口病 神经系统受累 临床预测规则 |
| DOI：10.3969/j.issn.1674-3806.2018.08.10 |
| 分类号:R 195 |
| 基金项目:国家自然科学基金资助项目(编号：81473030)；河南省医学科技攻关计划项目(编号：201403130)；河南省卫生系统出国研修项目(编号：2015065) |
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| Construction of a clinical prediction rule for hand-foot-mouth disease complicated with early neurological involvement |
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HUANG Ping, FENG Hui-fen, WANG Fang, et al.
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Department of Gastroenterology, the Fifth Affiliated Hospital of Zhengzhou University, Henan 450052, China
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| Abstract: |
| ［Abstract］ Objective To construct a clinical prediction rule(CPR) for hand-foot-mouth disease(HFMD) complicated with early neurological involvement. Methods The clinical data of 1 132 children with HFMD diagnosed were collected in the Children′s Hospital Affiliated to Zhengzhou University from January 2014 to February 2017. R Software Version 3.4.4 was used to analyze the data and the corresponding predictive variables were screened to construct a CPR for HFMD. ROC curve and calibration curve were used to evaluate the performance of the CPR. Results All the included cases were divided into mild group(n=695) and central nervous system(CNS) lesion group(n=437) depending on whether they had neurological involvement or not. The final constructed CPR included four independent risk factors: peak temperature ≥38.5 ℃, fever duration ≥3 days, WBC≥10.8×109/L, age<1 year(or 2 to 3 years old). The area under the diagnostic ROC curve was 0.821, with a sensitivity of 89.2%, a specificity of 80.7% and a cutoff value of 4 points. Conclusion The CPR constructed in this study has the advantages of being simple, practical and intuitive, and has a certain reference value for follow-up research and clinical practice. |
| Key words: Severe hand-foot-mouth disease(HFMD) Neurological involvement Clinical prediction rule(CPR) |
