Application and Comparison of Laboratory Parameters for Forecasting Severe Hand-Foot-Mouth Disease Using Logistic Regression, Discriminant Analysis and Decision Tree
Application and Comparison of Laboratory Parameters for Forecasting Severe Hand-Foot-Mouth Disease Using Logistic Regression, Discriminant Analysis and Decision Tree
复制标题
使用逻辑回归、判别分析和决策树预测严重手足口病的实验室参数的应用和比较
DOI：
10.7754/clin.lab.2015.150917
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发表时间：
2016-01-01
影响因子：
0.7
通讯作者：
Duan, Guangcai
中科院分区：
文献类型：
--
作者：
Sui, Meili;Huang, Xueyong;Duan, Guangcai
背景：近年来，手足口病在中国和其他一些国家的流行引起了全世界的关注。轻度病例往往在一周内恢复，而严重病例可能进展迅速，往往结果不好。由于没有手足口病疫苗，抗炎治疗并不理想。方法：回顾性收集2013 - 2015年郑州市儿童医院重症手足口病发病高峰期77例，同期77例轻症手足口病病例。该研究记录了常见的实验室参数，以协助建立重症手足口病模型。采用Mann-Whitney U检验筛选出重要变量后，再进行Logistic回归、判别分析和决策树分析进行比较。与轻度组比较，重度组WBC、PLT、PCT、MCV、MCH、LCR、SCR、LCC、GLO、CK-MB、K、S100、B水平均升高MCR、EOR、BASOR、SCC、MCC、EO、BASO、NA、CL、T、Th和Th/Ts均低于对照组（p < 0.05）。LR筛选出MCR、LCC、Th、CK-MB、CL 5个指标，DA筛选出5个指标，DT筛选出EO、LCC、CL、GLO、MCC 5个变量。LR、DA和DT的曲线下面积（AUC）分别为0.805、0.779和0.864。结论：LR、DA和DT可有效区分手足口病轻、重症，其中DT的分类效果最好，AUC为0.864。
Background: In recent years, the prevalence of hand-foot-mouth disease (HFMD) in China and some other countries has caused worldwide concern. Mild cases tend to recover within a week, while severe cases may progress rapidly and tend to have bad outcome. Since there is no vaccine for HFMD and anti-inflammatory treatment is not ideal. In this study, we aimed to establish a valid forecasting model for severe HFMD using common laboratory parameters.Methods: Retrospectively, 77 severe HFMD cases from Zhengzhou Children's hospital in the peaking period between years 2013 to 2015 were collected, with 77 mild HFMD cases in the same area. The study recorded common laboratory parameters to assist in establishment of the severe HFMD model. After screening the important variables using Mann-Whitney U test, the study also matched the logistic regression (LR), discriminant analysis (DA), and decision tree (DT) to make a comparison.Results: Compared with that of the mild group, serum levels of WBC, PLT, PCT, MCV, MCH, LCR, SCR, LCC, GLO, CK-MB, K, S100, and B in the severe group were higher (p < 0.05), while MCR, EOR, BASOR, SCC, MCC, EO, BASO, NA, CL, T, Th, and Th/Ts were lower (p < 0.05). Five indicators including MCR, LCC, Th, CK-MB, and CL were screened out by LR and the same for DA, and five variables including EO, LCC, CL, GLO, and MCC screened out by DT. The area under the curve (AUC) of LR, DA, and DT was 0.805, 0.779 and 0.864, respectively.Conclusions: The findings were that common laboratory indexes were effectively used to distinguish the mild HFMD cases and severe HFMD cases by LR, DA, and DT, and DT had the best classification effect with an AUC of 0.864.