预测VUR儿童突破性尿路感染的新型临床评分:元分析衍生和现实世界的验证
Honggang Fang1,2,3,4, Xianhai Yu1,2,3,4, Yihang Yu1,2,3,4
1Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China.
Pediatric nephrology (Berlin, Germany)
|November 27, 2025
概括
这项研究开发了一项八项风险评分,用于预测持续抗生素预防 (CAP) 带逆流 (VUR) 的儿童的突破性尿路感染 (BT-UTIs). 该得分有助于制定针对BT-UTI的个性化预防策略.
科学领域:
- 儿科病学 儿科病学
- 传染性疾病 传染性疾病
- 临床风险分层的临床风险分层
背景情况:
- 持续抗生素预防治疗 (CAP) 的膀外流 (VUR) 儿童的突破性尿路感染 (BT-UTIs) 是一个重大的临床挑战.
- 现有的BT-UTI风险分层方法有限,缺乏经过验证的预测工具.
研究的目的:
- 在儿童VUR患者中确定与BT-UTI相关的强有力的风险因素.
- 在这个人群中开发和验证基于证据的BT-UTI预测得分.
主要方法:
- 根据PRISMA和Cochrane指南,对队列研究进行了系统审查和元分析.
- 计算了聚合效应估计,并推导出了一个评分系统. 外部验证是在一个单独的队列上进行的.
- 搜索数据库包括PubMed,科学网络和Embase.
主要成果:
- 二十四个队列研究 (n=3,264) 显示,BT-UTI的综合发病率为30.5%.
- 确定了8个稳定的预测因素,并纳入了BT-UTI风险评分:年轻年龄,双边反流,高度反流,症状性尿路感染,复发性尿路感染史,膀和肠道功能障碍,尿路直径比率增加和DMSA脏痕形成.
- 外部验证证明了高分辨率 (AUC 0.88) 和临床效用,准确度很好 (0.84) 和灵敏度 (0.93) 在17点的截止值.
结论:
- 开发了一个由八项组成的BT-UTI风险评分,并对在CAP上患有VUR的儿童进行外部验证.
- 该得分显示出高度的歧视性和临床实用性,用于个性化风险分层.
- 该工具可以指导儿童VUR患者对BT-UTI的预防规划和实施.
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