Construction and validation of nomogram diagnosis model for EBV co-infection in children with Mycoplasma pneumoniae pneumonia
10.11816/cn.ni.2025-242172
- VernacularTitle:儿童肺炎支原体合并EB病毒感染的列线图诊断模型构建与验证
- Author:
Qi LIU
1
;
Hui MENG
1
;
Mingfeng SHAN
1
Author Information
1. 南京医科大学附属儿童医院感染科,江苏南京 210008
- Publication Type:Journal Article
- Keywords:
Mycoplasma pneumoniae pneumonia;
Epstein-Barr virus infection;
Risk factor;
Nomogram model
- From:
Chinese Journal of Nosocomiology
2025;35(12):1824-1828
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To construct a nomogram diagnosis model for Epstein-Barr virus(EBV)co-infection in children with Mycoplasma pneumoniae pneumonia(MPP).METHODS Clinical data of 427 children with MPP ad-mitted to the Children's Hospital of Nanjing Medical University from Jul.2020 to Jul.2024 were retrospectively analyzed.The children were divided into a modeling group(n=299)and a validation group(n=128).The model-ing group was further categorized into an MPP group(n=235)and an MPP co-infection group(n=64)based on EBV infection status.Multivariate logistic regression was used to identify risk factors for EBV co-infection in chil-dren with MPP,and a nomogram diagnosis model was constructed.The diagnostic value and clinical application value of the model were evaluated by receiver operating characteristic(ROC)curves,calibration curves and deci-sion curve analysis(DCA).RESULTS The white blood cell count(WBC)in the MPP co-infection group was(12.37±2.32)× 109/L,significantly higher than that in the MPP group(P<0.05).Platelet count(PLT)and hemoglobin(Hb)levels were(197.95±32.85)× 109/L and(102.58±13.74)g/L,respectively,lower than those in the MPP group(P<0.05).Additionally,the MPP co-infection group exhibited higher proportions of fe-ver duration ≥10 days,dyspnea and pleural effusion compared to the MPP group(P<0.05).Multivariate logistic regression analysis revealed that WBC(OR=1.514),PLT(OR=0.970),Hb(OR=0.959),fever duration(OR=4.790),dyspnea(OR=3.777)and pleural effusion(OR=4.795)were significantly associated with EBV infection in children with MPP(P<0.05).The nomogram demonstrated that when the total model score reached 219 points,the probability of EBV infection in children with MMP was 0.9.The areas under the ROC curve for the modeling group and validation group were 0.882(95%CI:0.836-0.927)and 0.943(95%CI:0.902-0.984),respectively,with sensitivities of 76.56%and 91.30%,respectively,and specificities of 82.55%and 85.71%,respectively.The Hosmer-Lemeshow goodness-of-fit test showed x2=4.124,P=0.846 for the modeling group and x2=4.203,P=0.838 for the validation group.DCA curve indicated high clinical applica-tion value of the model.CONCLUSIONS WBC,PLT,Hb levels,fever duration,dyspnea and pleural effusion have diagnostic values for EBV co-infection in children with MPP.The nomogram model constructed based on these six factors demonstrates excellent diagnostic performance.