基于潜变量增长混合模型的胃肠炎患儿疲劳发展轨迹及影响因素研究OA
Research on the fatigue development trajectory and influencing factors of children with gastroenteritis based on latent variable growth mixed model
目的 基于潜变量增长混合模型分析胃肠炎患儿疲劳发展轨迹及其影响因素.方法 采用便利抽样法,选取2023年7月至2025年6月于景德镇市妇幼保健院就诊的200例胃肠炎患儿为研究对象,收集患儿的人口学资料和疾病特征,分别于初次就诊、就诊3个月及就诊6个月时采用多维度疲劳量表评估患儿疲劳程度.通过潜变量增长混合模型识别胃肠炎患儿疲劳发展轨迹类别最优数量并进行分类命名;采用多因素Logistic回归分析潜在疲劳发展轨迹类别间的影响因素.结果 3类别模型的赤池信息量准则、贝叶斯信息准则、样本校正的贝叶斯信息准则均低于2类别模型,且Lo-Mendell-Rubin校正似然比检验与Bootstrap似然比检验均显著,信息熵均在0.8以上,表明其分类准确率高.根据综合模型适配指标与实际解释意义最终确定3类别模型为最优轨迹分类方案.其中低疲劳组66例(33%),起始疲劳水平较低,且在随访期间保持稳定;中疲劳缓解组70例(35%),起始疲劳水平中等,随时间推移呈缓慢下降趋势;高疲劳下降组64例(32%),起始疲劳水平较高,在随访过程中表现出明显的下降态势.三组患儿的年龄、体质量指数(body mass index,BMI)、贫血、疾病持续时间、家庭支持自评量表(perceived social support from family,PSS-Fa)评分比较差异均有统计学意义(P<0.05).多因素Logistic回归分析显示年龄、BMI、贫血、疾病持续时间、PSS-Fa评分均是胃肠炎患儿疲劳发展轨迹的影响因素(P<0.05).结论 胃肠炎患儿疲劳发展轨迹存在异质性,年龄、BMI、贫血、疾病持续时间、PSS-Fa评分均是胃肠炎患儿疲劳发展轨迹的影响因素.
Objective To analyze the fatigue development trajectory and its influencing factors in children with gastroenteritis using latent variable growth mixed model.Methods A total of 200 children with gastroenteritis who admitted Jingdezhen Maternal and Child Health Hospital from July 2023 to June 2025 were selected using convenience sampling.Demographic data and disease characteristics of children were collected.The multidimensional fatigue scale was used to assess the fatigue level of children at the time of the first visit,3 months after the visit,and 6 months after the visit.The optimal number of categories for the fatigue development trajectory of children with gastroenteritis was identified using latent variable growth mixed model and named accordingly.Multivariate Logistic regression was used to analyze the influencing factors between the potential categories.Results The Akaike information criterion,Bayesian information criterion and adjusted Bayesian information criterion of the 3-category model were all lower than those of the 2-category model,and both Lo-Mendell-Rubin adjusted likelihood ratio test and Bootstrap likelihood ratio test were significant.The information entropy values were all above 0.8,indicating high classification accuracy.Based on the comprehensive model adaptation indicators and practical interpretative significance,the 3-category model was determined as the optimal trajectory classification scheme.The low-fatigue group consisted of 66 cases(33％),and this group had a lower initial fatigue level and maintained stability during the follow-up period;the moderate-fatigue relief group had 70 cases(35％),initially at a moderate fatigue level,showing a slow downward trend over time;the high-fatigue decline group had 64 cases(32％),with a higher initial fatigue level,showing a significant downward trend during the follow-up.There were statistically significant differences in age,body mass index(BMI),anemia,disease duration,and perceived social support from family(PSS-Fa)scores among three groups of children(P<0.05).Multivariate Logistic regression analysis showed that age,BMI,anemia,disease duration,and PSS-Fa scores were factors influencing the course of fatigue in children with gastroenteritis.Conclusion The fatigue development trajectory of children with gastroenteritis shows heterogeneity.Age,BMI,anemia,disease duration,and PSS-Fa scores are the influencing factors of the fatigue development trajectory in children with gastroenteritis.
石红;吴庆敏
景德镇市妇幼保健院儿科住院部,江西 景德镇 333000景德镇市妇幼保健院儿科住院部,江西 景德镇 333000
医药卫生
潜变量增长混合模型胃肠炎儿童疲劳发展轨迹影响因素
Latent variable growth mixed modelGastroenteritisChildrenFatigueDevelopment trajectoryInfluencing factor
《中国现代医生》 2026 (22)
34-38,5
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