新生儿乳糖不耐受的影响因素及其预测效能分析
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江苏省宿迁市科技计划资助项目(K202118);


Analysis of factors influencing lactose intolerance in neonates and their predictive efficacy
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    摘要:

    目的:分析新生儿乳糖不耐受的影响因素,建立列线图预测模型并分析其预测效能。方法:选取307例新生儿作为研究对象,根据尿-半乳糖含量检测结果和临床症状分为乳糖不耐受组(n=59)和乳糖耐受组(n=248)。比较两组患儿临床资料,通过多因素Logistic回归筛选出影响因素并建立风险预测列线图模型。应用受试者工作特征(ROC)曲线、校准曲线、临床决策曲线检验模型的预测效果。结果:新生儿乳糖酶缺乏发生率64.1%(198/307);乳糖不耐受发生率19.22%(59/307);乳糖酶缺乏新生儿乳糖不耐受发生率29.8%(59/198)。日龄是新生儿发生乳糖不耐受的保护因素,有家族史、早产、配方奶喂养、肠内感染、使用抗生素、营养不良、贫血是新生儿发生乳糖不耐受的危险因素(P<0.05)。预测模型的ROC曲线显示曲线下面积(AUC)为0.924,敏感度为0.770,特异度为0.949,最佳约登指数为0.132;Hosmer-Lemeshow检验显示χ2=9.671,P>0.05。结论:新生儿乳糖不耐受的高危因素众多,基于上述因素构建的预测模型具有较好的预测效能,建议临床根据影响因素尽早合理使用干预措施,以改善新生儿乳糖不耐受的情况。

    Abstract:

    Objective:To analyze the influencing factors of neonatal lactose intolerance,develop a risk prediction model,and validate its predictive performance.Methods:A total of 307 neonates were selected as study subjects.Based on urine galactose test results and clinical manifestations,they were categorized into two groups:a lactose intolerance group(n=59)and a lactose tolerance group(n=248).By comparing the clinical data between the two groups,influencing factors were screened out using multivariate Logistic regression,and a risk prediction nomogram model was subsequently established.The predictive perform-ance of the model was assessed using the ROC curve,calibration curve,and clinical decision curve.Results:The incidence of lac-tase deficiency in newborns was 64.1%(198/307),the incidence of lactose intolerance was 19.22%(59/307),among newborns with lactase deficiency,the incidence of lactose intolerance was 29.8%(59/198).Gestational age serves as a protective factor a-gainst lactose intolerance in newborns,while a family history,prematurity,formula feeding,intestinal infection,antibiotic use,and malnutrition were risk factors for lactose intolerance in newborns(P<0.05).The ROC curve of the prediction model re-vealed an AUC of 0.924,with a sensitivity of 0.770,a specificity of 0.949,and an optimal Youden index of 0.132.The Hosmer-Lemeshow test showed x2=9.671,with P>0.05.Conclusion:Multiple high-risk factors contribute to neonatal lactose intoler-ance,and risk prediction models built upon these factors demonstrate good predictive efficacy.It is recommended that clinical in-terventions be implemented promptly and appropriately based on these influencing factors,in order to ameliorate the condition of lactose intolerance.

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尹瀚浚;张新;徐凡;刘涛;蒋亚洲;.新生儿乳糖不耐受的影响因素及其预测效能分析[J].川北医学院学报,2025,40(9):1169-1173.

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  • 在线发布日期: 2025-10-14
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