基于Cox模型的黄连对新生儿黄疸发病影响的研究

目的:了解黄连对新生儿黄疸发病的影响作用,为黄连的安全性用药提供依据。方法:回顾性调查412例新生儿黄疸患儿的临床资料,用Cox模型对其发病的影响因素进行单因素和多因素分析,建立预测方程,根据回归系数、相对危险度、wald值比较评价黄连对新生儿黄疸发病的影响作用。结果:单因素Cox模型分析显示影响新生儿黄疸发病的主要因素有5项,多因素Cox模型分析证明该5项也是影响新生儿黄疸发病的独立因素,按作用大小排列分别为年龄、应用黄连、民族、G6PD缺乏和剖宫产。其中,应用黄连的回归系数-0.259,相对危险度0.772,wald值6.832,是属于对新生儿黄疸发病具有降低危险度的保护因子。根据回归系数建立的影响新生儿黄疸发病的预测方程h(t,x)=h0(t)exp(-0.022x2-0.494x3+0.344x+0.226x-0.259x)。结论:黄连是影响新生儿黄疸发病的重要因素之一;黄连对新生儿黄疸的发病具有保护作用。

Research of coptis effect on incidence of neonatal jaundice based on Cox model

Objective : To learn the effects of coptis in treating neonatal jaundice and to find the index that guides the clinical administration of the medicine. Method : Clinical data of 412 cases of neonatal jaundice were studied retrospectively, and univariate and multivariate analysis were made to the factors affecting the incidence according to the Cox model which led to the establishment of the predictive equation. According to the regression coefficients, the relative risk, wald value, the coptis effects were evaluated on the incidence of neonatal jaundice. Result : Single-factor Cox model analysis shows that there are five main factors affecting the incidence of neonatal jaundice, Multivariate Cox model analysis indicates that the five main factors are also independent factors that affect the incidence, the roles of which, ranking from minor to major are, in turn, age, applied coptis, ethnic, G6PD deficiency and cesarean section. Among them, the regression coefficient is -0.259, relative risk 0.772, wald value 6.832. It sugguests that coptis may reduce the incidence of neonatal jaundice, and that it is a protective factor. The prediction equation, by regression coefficients, which has been used to establish the incidence of neonatal jaundice, is as following: h(t,x)=h₀(t)exp(-0.022x₂-0.494x₃+0.344x₈ +0.226x₉ -0.259x₁₀). Conclusion : Coptis is one of the important factors that affect the occurrence of neonatal jaundice, and it has a protective effect in preventing neonatal jaundice from occurrence.