[1]杜香楠,陆裕铤,罗霄霄,等.腺样体肥大患儿合并下呼吸道感染的危险因素列线图预测模型构建[J].医学信息,2026,39(02):47-51.[doi:10.3969/j.issn.1006-1959.2026.02.008]
　DU Xiangnan,LU Yuting,LUO Xiaoxiao,et al.Construction of a Nomogram Prediction Model for Risk Factors of Adenoidal HypertrophyComplicated with Lower Respiratory Tract Infection in Children[J].Journal of Medical Information,2026,39(02):47-51.[doi:10.3969/j.issn.1006-1959.2026.02.008]
点击复制

腺样体肥大患儿合并下呼吸道感染的危险因素列线图预测模型构建()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
39卷
期数:
2026年02期
页码:
47-51
栏目:
临床信息学
出版日期:
2026-01-15

文章信息/Info

Title:
Construction of a Nomogram Prediction Model for Risk Factors of Adenoidal HypertrophyComplicated with Lower Respiratory Tract Infection in Children
文章编号:
1006-1959（2026）02-0047-05
作者:
杜香楠1; 2; 陆裕铤1; 2; 罗霄霄1; 2; 曹晓林2
1.浙江中医药大学第四临床医学院，浙江 杭州 310053；2.西湖大学医学院附属杭州市第一人民医院耳鼻咽喉头颈外科，浙江 杭州 3100
Author(s):
DU Xiangnan1; 2;  LU Yuting1; 2;  LUO Xiaoxiao1; 2;  CAO Xiaolin2
1.The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China;2.Department of Otolaryngology Head and Neck Surgery, Affiliated Hangzhou First People′s Hospital, School of Medicine, Westlake University, Hangzhou 310006, Zhejiang, China
关键词:
腺样体肥大; 下呼吸道感染; 危险因素; 列线图
Keywords:
Adenoid hypertrophy;  Lower respiratory tract infections;  Risk factors;  Nomogram
分类号:
R766；R725.
DOI:
10.3969/j.issn.1006-1959.2026.02.008
文献标志码:
A
摘要:
目的 定量评估儿童腺样体肥大（AH）合并下呼吸道感染（LRTIs）的发病风险。方法 收集2024年1月-2025年2月于西湖大学医学院附属杭州市第一人民医院行腺样体切除术的243例患儿的临床资料，根据是否合并LRTIs分为合并LRTIs组和未合并LRTIs组。通过独立样本t检验、χ２检验进行单因素分析，通过多因素Logistic分析筛选与LRTIs相关的独立危险因素并构建可视化列线图预测模型，通过受试者工作特征（ROC）曲线评估模型诊断效能、临床决策曲线（DCA）判断模型的临床应用价值、校准曲线图表示模型的预测准确度。结果 单因素分析显示AH患儿合并LRTIs与患儿年龄、BMI指数、过敏原阳性、反复上呼吸道感染史、哮喘病史、分泌性中耳炎病史、被动吸烟、运动频率、运动时间有关（P＜0.05）。多因素分析结果显示，反复上呼吸道感染史、分泌性中耳炎病史是LRTIs的危险因素（OR=4.859、3.069），而运动时间≥30 min/次（OR=0.266）为保护性因素，差异均有统计学意义（P＜0.05）。基于以上危险因素构建相关列线图预测模型，经评估显示该模型的AUC为0.78（95%CI：0.70~0.86），提示列线图模型具有较准确的预测能力。结论 本研究使用列线图方法建立的预测模型有助于对临床工作中对儿童AH合并LRTIs情况进行风险预测,以便尽早对高危患儿进行预防和治疗。
Abstract:
Objective To quantitatively assess the risk of adenoidal hypertrophy (AH) complicated with lower respiratory tract infections (LRTIs) in children. Methods The clinical data of 243 children who underwent adenoidectomy in Affiliated Hangzhou First People′s Hospital, School of Medicine, Westlake University from January 2024 to February 2025 were collected. According to whether LRTIs were combined, they were divided into LRTIs group and non-LRTIs group. Univariate analysis was performed by independent sample t test and χ2 test. Multivariate Logistic analysis was used to screen independent risk factors related to LRTIs and construct a visual nomogram prediction model. The diagnostic efficacy of the model was evaluated by receiver operating characteristic (ROC) curve. The clinical application value of the model was judged by clinical decision curve (DCA), and the prediction accuracy of the model was represented by calibration curve. Results Univariate analysis showed that AH children with LRTIs were related to age, BMI index, positive allergen, history of repeated upper respiratory tract infection, history of asthma, history of secretory otitis media, passive smoking, exercise frequency and exercise time (P<0.05). Multivariate analysis showed that history of recurrent upper respiratory tract infection and secretory otitis media were risk factors for LRTIs (OR=4.859, 3.069), while exercise time ≥30 min/time (OR=0.266) was a protective factor, the differences were statistically significant (P<0.05). Based on the above risk factors, a related nomogram prediction model was constructed. The evaluation showed that the AUC of the model was 0.78 (95%CI: 0.70-0.86), suggesting that the nomogram model had a more accurate predictive ability. Conclusion The prediction model established by the nomogram method in this study is helpful to predict the risk of AH combined with LRTIs in children during clinical work, so as to prevent and treat high-risk children as soon as possible.

参考文献/References:

[1]Niedzielski A,Chmielik LP,Mielnik-Niedzielska G,et al.Adenoid hypertrophy in children: a narrative review of pathogenesis and clinical relevance[J].BMJ Paediatr Open,2023,7(1):e001710.[2]Xu Z,Wu Y,Tai J,et al.Risk factors of obstructive sleep apnea syndrome in children[J].J Otolaryngol Head Neck Surg,2020,49(1):11.[3]?覶etkin M,?覶etkin HE.Adjunctive Treatment of Pediatric Adenoidal Hypertrophy: A Review[J].Altern Ther Health Med,2023,29(5):46-53.[4]Demissie BW,Amele EA,Yitayew YA,et al.Acute lower respiratory tract infections and associated factors among under-five children visiting Wolaita Sodo University Teaching and Referral Hospital, Wolaita Sodo, Ethiopia[J].BMC Pediatr,2021,21(1):413.[5]Wahab A.Global trend and disparity of acute lower respiratory infection as cause of mortality in children under 5 years of age[J].Clin Exp Pediatr,2021,64(12):630-631.[6]Ungkanont K,Jootakarn S,Leelaporn A,et al.Association between adenoid bacteriology and clinical characteristics of adenoid-related diseases in children[J].SAGE Open Med,2021,9:20503121211006005.[7]Niu X,Wu ZH,Xiao XY,et al The relationship between adenoid hypertrophy and gastroesophageal reflux disease: A meta-analysis[J].Medicine (Baltimore),2018,97(41):e12540.[8]Bugova G,Janickova M,Uhliarova B,et al.The effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children[J].Acta Otorhinolaryngol Ital,2018,38(5):431-438.[9]Zhang J,Fu Y,Wang L,et al.Adenoid facies: a long-term vicious cycle of mouth breathing, adenoid hypertrophy, and atypical craniofacial development[J].Front Public Health,2024,12: 1494517.[10]Zelasko S,Swaney MH,Sandstrom S,et al.Early-life upper airway microbiota are associated with decreased lower respiratory tract infections[J].J Allergy Clin Immunol,2025,155(2):436-450.[11]Liu A,Zhang Y,Lin Y,et al.A rat model of adenoid hypertrophy constructed by using ovalbumin and lipopolysaccharides to induce allergy, chronic inflammation, and chronic intermittent hypoxia[J].Animal Model Exp Med,2025,8(2):353-362.[12]Passalacqua G,Canonica GW.Impact of rhinitis on airway inflammation: biological and therapeutic implications[J].Respir Res,2001,2(6):320-323.[13]Yaz?覦c?覦 H.Nasal Mucociliary Clearance in Adenoid Hypertrophy and Otitis Media with Effusion[J].Curr Allergy Asthma Rep,2015,15(12):74.[14]Nguyen LH,Manoukian JJ,Sobol SE,et al.Similar allergic inflammation in the middle ear and the upper airway: evidence linking otitis media with effusion to the united airways concept[J].J Allergy Clin Immunol,2004,114(5):1110-1115.[15]Mashat GD,Tran HH,Urgessa NA,et al.The Correlation Between Otitis Media With Effusion and Adenoid Hypertrophy Among Pediatric Patients: A Systematic Review[J].Cureus,2022,14(11):e30985.[16]Nourizadeh N,Ghazvini K,Gharavi V,et al.Evaluation of nasopharyngeal microbial flora and antibiogram and its relation to otitis media with effusion[J].Eur Arch Otorhinolaryngol,2016,273(4):859-863.[17]Pazdro-Zastawny K,Kolator M,Krajewska J,et al.Lifestyle-related factors differentiating the prevalence of otorhinolaryngological diseases among 6-17-year-olds from Wroc?aw, Poland[J].Int J Pediatr Otorhinolaryngol,2020,132:109934.[18]Strom MA,Silverberg JI.Associations of Physical Activity and Sedentary Behavior with Atopic Disease in United States Children[J].J Pediatr,2016,174:247-253.e3.[19]Jedrychowski W,Maugeri U,Flak E,et al.Cohort study on low physical activity level and recurrent acute respiratory infections in schoolchildren[J].Cent Eur J Public Health,2001,9(3):126-129.[20]Bae JY,Jang KS,Kang S,et al.Correlation between basic physical fitness and pulmonary function in Korean children and adolescents: a cross-sectional survey[J].J Phys Ther Sci,2015,27(9):2687-2692.

相似文献/References:

[1]杨 磊.等离子射频消融术治疗腺样体肥大对术中创伤程度和术后免疫功能的影响分析[J].医学信息,2018,31(04):98.[doi:10.3969/j.issn.1006-1959.2018.04.032]
　YANG Lei.Effect of Plasma Radiofrequency Ablation on Intraoperative Trauma and Postoperative Immune Function in Patients with Adenoid Hypertrophy[J].Journal of Medical Information,2018,31(02):98.[doi:10.3969/j.issn.1006-1959.2018.04.032]
[2]于文清.下呼吸道感染病原菌分布及耐药性分析[J].医学信息,2018,31(24):74.[doi:10.3969/j.issn.1006-1959.2018.24.019]
　YU Wen-qing.Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Lower Respiratory Tract Infection[J].Journal of Medical Information,2018,31(02):74.[doi:10.3969/j.issn.1006-1959.2018.24.019]
[3]曾小兰.阿莫西林-克拉维酸钾、左氧氟沙星治疗下呼吸道感染的疗效及成本-效果分析[J].医学信息,2022,35(18):77.[doi:10.3969/j.issn.1006-1959.2022.18.019]
　ZENG Xiao-lan.Efficacy and Cost-effectiveness Analysis of Amoxicillin-clavulanate Potassium and Levofloxacin in Treatment of Lower Respiratory Tract Infection[J].Journal of Medical Information,2022,35(02):77.[doi:10.3969/j.issn.1006-1959.2022.18.019]
[4]牛春生.孟鲁司特钠联合糠酸莫米松治疗过敏性鼻炎致轻中度腺样体肥大的效果[J].医学信息,2020,33(22):153.[doi:10.3969/j.issn.1006-1959.2020.22.044]
　NIU Chun-sheng.The Effect of Montelukast Sodium Combined with Mometasone Furoate in the Treatment of Mild to Moderate Adenoid Hypertrophy Caused by Allergic Rhinitis[J].Journal of Medical Information,2020,33(02):153.[doi:10.3969/j.issn.1006-1959.2020.22.044]
[5]塔吉努尔·居来提,木亚斯尔·艾比布拉.儿童下呼吸道流感病毒感染危重症的临床特征分析[J].医学信息,2023,36(05):127.[doi:10.3969/j.issn.1006-1959.2023.05.024]
　Tajinuer·Julaiti,Muyasier·Aibibula.Analysis of Clinical Characteristics of Children with Severe Lower Respiratory Tract Influenza Virus Infection[J].Journal of Medical Information,2023,36(02):127.[doi:10.3969/j.issn.1006-1959.2023.05.024]
[6]沈旭峰.COPD患者下呼吸道感染的病原菌分布及耐药性分析[J].医学信息,2021,34(19):146.[doi:10.3969/j.issn.1006-1959.2021.19.039]
　SHEN Xu-feng.Analysis of Pathogen Distribution and Drug Resistance of Lower Respiratory Tract Infection in Chronic Obstructive Pulmonary Disease Patients[J].Journal of Medical Information,2021,34(02):146.[doi:10.3969/j.issn.1006-1959.2021.19.039]
[7]苏 涛,汤 锋,朱美红.口呼出一氧化氮水平检测在腺样体肥大患儿中的应用价值[J].医学信息,2024,37(02):143.[doi:10.3969/j.issn.1006-1959.2024.02.029]
　SU Tao,TANG Feng,ZHU Mei-hong.Application Value of Fraction of Exhaled Nitric Oxide Detection in Children with Adenoidal Hypertrophy[J].Journal of Medical Information,2024,37(02):143.[doi:10.3969/j.issn.1006-1959.2024.02.029]
[8]何 兵,王君君,张 迪,等.儿童下呼吸道感染的病原体分布及胸部影像学特点分析[J].医学信息,2025,38(07):87.[doi:10.3969/j.issn.1006-1959.2025.07.015]
　HE Bing,WANG Junjun,ZHANG Di,et al.Analysis of Pathogen Distribution and Chest Imaging Characteristics of Lower Respiratory Tract Infection in Children[J].Journal of Medical Information,2025,38(02):87.[doi:10.3969/j.issn.1006-1959.2025.07.015]
[9]王 勇,王 敬,上官维晶.急性下呼吸道感染患儿并发哮喘的Nomogram预测模型的构建[J].医学信息,2025,38(21):8.[doi:10.3969/j.issn.1006-1959.2025.21.002]
　WANG Yong,WANG Jing,SHANGGUAN Weijing.Construction of a Nomogram Model for Asthma in Childrenwith Acute Lower Respiratory Tract Infection[J].Journal of Medical Information,2025,38(02):8.[doi:10.3969/j.issn.1006-1959.2025.21.002]
[10]张 昊.注射用头孢哌酮钠舒巴坦钠仿制药与原研药治疗下呼吸道感染的有效性与安全性比较[J].医学信息,2026,39(04):149.[doi:10.3969/j.issn.1006-1959.2026.04.027]
　ZHANG Hao.Comparison of Efficacy and Safety of Generic Drug and Originator Drug of Cefoperazone Sodiumand Sulbactam Sodium for Injection in the Treatment of Lower Respiratory Tract Infection[J].Journal of Medical Information,2026,39(02):149.[doi:10.3969/j.issn.1006-1959.2026.04.027]

更新日期/Last Update: 1900-01-01