新生兒黃疸陰陽(yáng)屬性影響因素及Bayes概率模型初步構(gòu)建
發(fā)布時(shí)間：2018-11-01 16:51
【摘要】：目的：1.探討新生兒黃疸陰陽(yáng)屬性的影響因素；2.構(gòu)建陰黃證及陽(yáng)黃證的Bayes概率模型并評(píng)價(jià)模型在新生兒黃疸陰陽(yáng)屬性判別中的應(yīng)用價(jià)值。方法：病例選擇生后10天內(nèi)入院的新生兒黃疸107例，記錄分析可能與黃疸有關(guān)的新生兒胎內(nèi)、出生及生后因素。對(duì)入選病例按照傳統(tǒng)中醫(yī)辨證方法進(jìn)行辨證分型，其中陽(yáng)黃組68例，陰黃組39例。于入院當(dāng)日或次日進(jìn)行血常規(guī)、肝功、腎功、心肌酶等指標(biāo)檢查，如實(shí)、完整地填寫(xiě)記錄表格，并跟蹤患兒的臨床過(guò)程。建立數(shù)據(jù)庫(kù)，應(yīng)用SPSS17.0統(tǒng)計(jì)軟件包進(jìn)行統(tǒng)計(jì)學(xué)分析，篩選有統(tǒng)計(jì)學(xué)意義的單因素；應(yīng)用非條件Logistic回歸模型及Bayes判別分析篩選有陽(yáng)性意義的指標(biāo)；建立陰黃證及陽(yáng)黃證的Bayes概率模型并進(jìn)行評(píng)價(jià)。結(jié)果：1.新生兒黃疸陰陽(yáng)屬性的影響因素：在產(chǎn)前因素單因素分析中，母親年齡超過(guò)35歲、喜食涼食、合并妊娠期糖尿病的比率在陰黃組明顯增高，而高蛋白飲食比率在陽(yáng)黃組較高（均P＜0.05）；在產(chǎn)時(shí)因素中，第二產(chǎn)程延長(zhǎng)、新生兒窒息的發(fā)生率陰黃組較陽(yáng)黃組明顯增高（均P＜0.05）；產(chǎn)后因素中，胎齡、出生體質(zhì)量、出生體質(zhì)量/胎齡陰黃組較陽(yáng)黃組低（均P＜0.05）；早產(chǎn)兒、紅細(xì)胞增多癥患兒及冬季出生的患兒比率陰黃組較陽(yáng)黃組高（均P＜0.05）；而新生兒ABO溶血病發(fā)生率則在陽(yáng)黃組明顯增高（P＜0.05）。在理化指標(biāo)中，，陰黃組患兒HCT、MCV、RDW-SD、PDW、P-LCR、DBIL、GGT、ALP、CHE、ADA等項(xiàng)均較陽(yáng)黃組患兒增高，差異有統(tǒng)計(jì)學(xué)意義（均P＜0.05）。2.陰黃證及陽(yáng)黃證Bayes概率模型的構(gòu)建：將陰黃、陽(yáng)黃兩組單因素分析中差異有統(tǒng)計(jì)學(xué)意義的因素進(jìn)一步引入非條件Logistic回歸模型及Bayes判別分析篩選有陽(yáng)性意義的指標(biāo)。對(duì)新生兒黃疸陰陽(yáng)屬性有陽(yáng)性意義的指標(biāo)為：母親年齡、妊娠期糖尿病、胎齡、窒息、ABO溶血病、RDW-SD、LCR、DBIL、ALP及CHE。利用SPSS進(jìn)行Bayes判別分析，得到Bayes判別函數(shù)系數(shù)。根據(jù)判別函數(shù)系數(shù)建立Bayes判別函數(shù)：陽(yáng)黃y1=－21.701+2.589×母親年齡+1.037×糖尿病-17.175×窒息+13.876×胎齡+6.303×ABO+2.116×RDW-SD+0.831×DBIL+0.012×ALP+1.697×LCR+0.001×CHE；陰黃y2=－33.511+2.991×母親年齡+3.960×糖尿病-12.877×窒息+11.848×胎齡+1.820×ABO+2.231×RDW-SD+0.999×DBIL+0.023×ALP+1.916×LCR+0.002×CHE。對(duì)判別函數(shù)進(jìn)行假設(shè)檢驗(yàn)，判別函數(shù)有統(tǒng)計(jì)學(xué)意義（統(tǒng)計(jì)量Wilks’λ=0.393，P=0.000）。對(duì)判別函數(shù)進(jìn)行考核，陰黃及陽(yáng)黃的符合率均在90%以上，有較高的應(yīng)用價(jià)值。結(jié)論：1.新生兒黃疸的陰陽(yáng)屬性與多因素有關(guān)，其中母親年齡超過(guò)35歲、喜食涼食、合并妊娠期糖尿病、第二產(chǎn)程延長(zhǎng)及新生兒低胎齡、低出生體質(zhì)量、窒息、紅細(xì)胞增多癥、出生在冬季是促進(jìn)陰黃證發(fā)生的因素；而母親高蛋白飲食、新生兒原發(fā)病為ABO溶血病則是陽(yáng)黃證發(fā)生的影響因素。2.通過(guò)構(gòu)建Bayes概率模型可以較準(zhǔn)確地判別新生兒黃疸的陰陽(yáng)屬性。
[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.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：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.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R722.1
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 鄧長(zhǎng)柏,朱萍;新生兒高間接膽紅素血癥病因及臨床分析[J];中國(guó)當(dāng)代兒科雜志;2001年01期
2 辛建梅;鄭彬;傅松波;;新生兒黃疸患兒體內(nèi)氧化應(yīng)激狀態(tài)變化的觀察[J];甘肅醫(yī)藥;2009年03期
3 張t
本文編號(hào)：2304515
本文鏈接：http://sikaile.net/yixuelunwen/eklw/2304515.html
最近更新
教材專(zhuān)著
