新生儿黄疸阴阳属性影响因素及Bayes概率模型初步构建
发布时间：2018-11-01 16:51
【摘要】：目的：1.探讨新生儿黄疸阴阳属性的影响因素；2.构建阴黄证及阳黄证的Bayes概率模型并评价模型在新生儿黄疸阴阳属性判别中的应用价值。方法：病例选择生后10天内入院的新生儿黄疸107例，记录分析可能与黄疸有关的新生儿胎内、出生及生后因素。对入选病例按照传统中医辨证方法进行辨证分型，其中阳黄组68例，阴黄组39例。于入院当日或次日进行血常规、肝功、肾功、心肌酶等指标检查，如实、完整地填写记录表格，并跟踪患儿的临床过程。建立数据库，应用SPSS17.0统计软件包进行统计学分析，筛选有统计学意义的单因素；应用非条件Logistic回归模型及Bayes判别分析筛选有阳性意义的指标；建立阴黄证及阳黄证的Bayes概率模型并进行评价。结果：1.新生儿黄疸阴阳属性的影响因素：在产前因素单因素分析中，母亲年龄超过35岁、喜食凉食、合并妊娠期糖尿病的比率在阴黄组明显增高，而高蛋白饮食比率在阳黄组较高（均P＜0.05）；在产时因素中，第二产程延长、新生儿窒息的发生率阴黄组较阳黄组明显增高（均P＜0.05）；产后因素中，胎龄、出生体质量、出生体质量/胎龄阴黄组较阳黄组低（均P＜0.05）；早产儿、红细胞增多症患儿及冬季出生的患儿比率阴黄组较阳黄组高（均P＜0.05）；而新生儿ABO溶血病发生率则在阳黄组明显增高（P＜0.05）。在理化指标中，，阴黄组患儿HCT、MCV、RDW-SD、PDW、P-LCR、DBIL、GGT、ALP、CHE、ADA等项均较阳黄组患儿增高，差异有统计学意义（均P＜0.05）。2.阴黄证及阳黄证Bayes概率模型的构建：将阴黄、阳黄两组单因素分析中差异有统计学意义的因素进一步引入非条件Logistic回归模型及Bayes判别分析筛选有阳性意义的指标。对新生儿黄疸阴阳属性有阳性意义的指标为：母亲年龄、妊娠期糖尿病、胎龄、窒息、ABO溶血病、RDW-SD、LCR、DBIL、ALP及CHE。利用SPSS进行Bayes判别分析，得到Bayes判别函数系数。根据判别函数系数建立Bayes判别函数：阳黄y1=－21.701+2.589×母亲年龄+1.037×糖尿病-17.175×窒息+13.876×胎龄+6.303×ABO+2.116×RDW-SD+0.831×DBIL+0.012×ALP+1.697×LCR+0.001×CHE；阴黄y2=－33.511+2.991×母亲年龄+3.960×糖尿病-12.877×窒息+11.848×胎龄+1.820×ABO+2.231×RDW-SD+0.999×DBIL+0.023×ALP+1.916×LCR+0.002×CHE。对判别函数进行假设检验，判别函数有统计学意义（统计量Wilks’λ=0.393，P=0.000）。对判别函数进行考核，阴黄及阳黄的符合率均在90%以上，有较高的应用价值。结论：1.新生儿黄疸的阴阳属性与多因素有关，其中母亲年龄超过35岁、喜食凉食、合并妊娠期糖尿病、第二产程延长及新生儿低胎龄、低出生体质量、窒息、红细胞增多症、出生在冬季是促进阴黄证发生的因素；而母亲高蛋白饮食、新生儿原发病为ABO溶血病则是阳黄证发生的影响因素。2.通过构建Bayes概率模型可以较准确地判别新生儿黄疸的阴阳属性。
[Abstract]:Purpose 1. To explore the influence factors of neonate jaundice. 2. To construct the Bayes probability model of Yin-Huang syndrome and Yang-yellow syndrome and to evaluate the application value of the model in the identification of yin-yang attribute of neonatal jaundice. Methods: 107 cases of neonatal jaundice were selected from 10 days after birth. The fetal, birth and postnatal factors were recorded and analyzed. The selected cases were classified according to the traditional Chinese medicine syndrome differentiation method, including 68 cases of Yang Huang group and 39 cases of yin yellow group. Blood routine examination, liver function, kidney function, myocardial enzyme examination were carried out on the day or the next day of admission, the record forms were filled out truthfully and the clinical process of the children was tracked. The database was established and the statistical analysis was carried out by using SPSS17.0 statistical software package to screen the single factor with statistical significance, and the non-conditional Logistic regression model and Bayes discriminant analysis were used to screen the positive indexes. The Bayes probabilistic model of Yin-Huang syndrome and Yang Huang syndrome was established and evaluated. Results: 1. Influencing factors of Yin and Yang attribute of Neonatal jaundice: in the single factor analysis of prenatal factors, the maternal age was over 35 years old, she preferred to eat cold food, and the rate of gestational diabetes mellitus was significantly higher in the yin-yellow group. The ratio of high-protein diet was higher in Yang Huang group (all P < 0.05). The incidence of neonatal asphyxia was significantly higher in Yin-Huang group than in Yang-Huang group (all P < 0.05). The postpartum factors, gestational age, birth weight / gestational age of yin-yellow group were lower than that of Yang Huang group (all P < 0.05). The rate of ABO hemolytic disease in premature infants, polycythemia children and children born in winter was higher than that in yanghuang group (P < 0. 05), while the incidence of neonatal ABO hemolytic disease was significantly higher in yang Huang group (P < 0. 05). In physical and chemical indexes, the HCT,MCV,RDW-SD,PDW,P-LCR,DBIL,GGT,ALP,CHE,ADA and other items in Yin-Huang group were significantly higher than those in Yang Huang group (all P < 0. 05). Construction of Bayes probabilistic Model of Yin-Huang Syndrome and Yang-Huang Syndrome: the factors with statistical significance in univariate analysis of Yin-Huang and Yang-Huang were further introduced into non-conditional Logistic regression model and Bayes discriminant analysis to screen positive indexes. The positive indicators for the yin-yang attribute of neonatal jaundice are: age of mother, gestational diabetes mellitus, gestational age, asphyxia, ABO hemolytic disease, RDW-SD,LCR,DBIL,ALP and CHE.. The coefficient of Bayes discriminant function is obtained by Bayes discriminant analysis with SPSS. According to the discriminant function coefficient, the Bayes discriminant function was established: Yanghuang y1c-21.701 2.589 脳 maternal age 1.037 脳 DM -17.175 脳 asphyxia 13.876 脳 gestational age 6.303 脳 ABO 2.116 脳 RDW-SD 0.831 脳 DBIL 0.012 脳 ALP 1.697 脳 LCR 0.001 脳 CHE; Yin Huang Y2C -33.511 2.991 脳 maternal age 3.960 脳 DM-12.877 脳 asphyxia 11.848 脳 gestational age 1.820 脳 ABO 2.231 脳 RDW-SD 0.999 脳 DBIL 0.023 脳 ALP 1.916 脳 LCR 0.002 脳 CHE. The hypothesis test of the discriminant function shows that the discriminant function has statistical significance (Wilks' 位 = 0.393P0. 000). The coincidence rate of yin-yellow and Yang-yellow is above 90%, which has high application value. Conclusion 1. The yin-yang attribute of neonate jaundice is related to many factors, including mother over 35 years old, eating cold food, complicating gestational diabetes mellitus, prolonging the second stage of labor and low gestational age of newborn, low birth weight, asphyxia, polycythemia, etc. Birth in winter is a factor to promote the occurrence of Yin-Huang syndrome. The maternal high protein diet, the primary disease of newborn ABO hemolytic disease is the influence factor of yang yellow syndrome. 2. 2. By constructing the Bayes probability model, we can accurately distinguish the yin and yang attributes of neonatal jaundice.
【学位授予单位】：山东中医药大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R722.1
[Abstract]:Purpose 1. To explore the influence factors of neonate jaundice. 2. To construct the Bayes probability model of Yin-Huang syndrome and Yang-yellow syndrome and to evaluate the application value of the model in the identification of yin-yang attribute of neonatal jaundice. Methods: 107 cases of neonatal jaundice were selected from 10 days after birth. The fetal, birth and postnatal factors were recorded and analyzed. The selected cases were classified according to the traditional Chinese medicine syndrome differentiation method, including 68 cases of Yang Huang group and 39 cases of yin yellow group. Blood routine examination, liver function, kidney function, myocardial enzyme examination were carried out on the day or the next day of admission, the record forms were filled out truthfully and the clinical process of the children was tracked. The database was established and the statistical analysis was carried out by using SPSS17.0 statistical software package to screen the single factor with statistical significance, and the non-conditional Logistic regression model and Bayes discriminant analysis were used to screen the positive indexes. The Bayes probabilistic model of Yin-Huang syndrome and Yang Huang syndrome was established and evaluated. Results: 1. Influencing factors of Yin and Yang attribute of Neonatal jaundice: in the single factor analysis of prenatal factors, the maternal age was over 35 years old, she preferred to eat cold food, and the rate of gestational diabetes mellitus was significantly higher in the yin-yellow group. The ratio of high-protein diet was higher in Yang Huang group (all P < 0.05). The incidence of neonatal asphyxia was significantly higher in Yin-Huang group than in Yang-Huang group (all P < 0.05). The postpartum factors, gestational age, birth weight / gestational age of yin-yellow group were lower than that of Yang Huang group (all P < 0.05). The rate of ABO hemolytic disease in premature infants, polycythemia children and children born in winter was higher than that in yanghuang group (P < 0. 05), while the incidence of neonatal ABO hemolytic disease was significantly higher in yang Huang group (P < 0. 05). In physical and chemical indexes, the HCT,MCV,RDW-SD,PDW,P-LCR,DBIL,GGT,ALP,CHE,ADA and other items in Yin-Huang group were significantly higher than those in Yang Huang group (all P < 0. 05). Construction of Bayes probabilistic Model of Yin-Huang Syndrome and Yang-Huang Syndrome: the factors with statistical significance in univariate analysis of Yin-Huang and Yang-Huang were further introduced into non-conditional Logistic regression model and Bayes discriminant analysis to screen positive indexes. The positive indicators for the yin-yang attribute of neonatal jaundice are: age of mother, gestational diabetes mellitus, gestational age, asphyxia, ABO hemolytic disease, RDW-SD,LCR,DBIL,ALP and CHE.. The coefficient of Bayes discriminant function is obtained by Bayes discriminant analysis with SPSS. According to the discriminant function coefficient, the Bayes discriminant function was established: Yanghuang y1c-21.701 2.589 脳 maternal age 1.037 脳 DM -17.175 脳 asphyxia 13.876 脳 gestational age 6.303 脳 ABO 2.116 脳 RDW-SD 0.831 脳 DBIL 0.012 脳 ALP 1.697 脳 LCR 0.001 脳 CHE; Yin Huang Y2C -33.511 2.991 脳 maternal age 3.960 脳 DM-12.877 脳 asphyxia 11.848 脳 gestational age 1.820 脳 ABO 2.231 脳 RDW-SD 0.999 脳 DBIL 0.023 脳 ALP 1.916 脳 LCR 0.002 脳 CHE. The hypothesis test of the discriminant function shows that the discriminant function has statistical significance (Wilks' 位 = 0.393P0. 000). The coincidence rate of yin-yellow and Yang-yellow is above 90%, which has high application value. Conclusion 1. The yin-yang attribute of neonate jaundice is related to many factors, including mother over 35 years old, eating cold food, complicating gestational diabetes mellitus, prolonging the second stage of labor and low gestational age of newborn, low birth weight, asphyxia, polycythemia, etc. Birth in winter is a factor to promote the occurrence of Yin-Huang syndrome. The maternal high protein diet, the primary disease of newborn ABO hemolytic disease is the influence factor of yang yellow syndrome. 2. 2. By constructing the Bayes probability model, we can accurately distinguish the yin and yang attributes of neonatal jaundice.
【学位授予单位】：山东中医药大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R722.1
【参考文献】
相关期刊论文 前10条
1 邓长柏,朱萍;新生儿高间接胆红素血症病因及临床分析[J];中国当代儿科杂志;2001年01期
2 辛建梅;郑彬;傅松波;;新生儿黄疸患儿体内氧化应激状态变化的观察[J];甘肃医药;2009年03期
3 张t
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