儿童偏矮身材的中医体质分布及风险预测模型构建

目的 调查北京市海淀区学龄前儿童偏矮身材的中医体质和其他影响因素并构建风险预测模型，为儿童偏矮身材的防治提供参考。方法 运用整群抽样和问卷调查方法，共纳入1 612例北京市海淀区学龄前儿童作为研究对象。偏矮身材影响因素的效应大小用比值比（odds ratio，OR）及其95%置信区间（confidence interval，CI）表示。使用STATA 14.0进行统计分析，采用R软件绘制列线图风险预测模型。结果 儿童偏矮身材检出率为14.0%。偏矮身材组和正常身高组阴虚质的分布差异有统计学意义（P<0.05）。多因素Logistic回归分析显示偏矮身材的显著影响因素是父亲身高（OR=0.90，95% CI为0.87~0.93，P=0.000）、母亲身高（OR=0.89，95% CI为0.86~0.92，P=0.000）、出生身长（OR=0.92，95% CI为0.87~0.97，P=0.002）、出生体质量（OR=0.48，95%CI为0.36~0.65，P=0.000）、母乳喂养时间大于12个月（OR=1.51，95% CI为1.11~2.05，P=0.008）、阴虚质（OR=1.19，95% CI为1.01~1.39，P=0.038）。根据显著影响因素构建列线图风险预测模型，一致性指数为71.0%（P<0.001）。结论 儿童偏矮身材可能是遗传、出生情况、母乳喂养和中医体质多因素影响作用的结果。

Distribution of Traditional Chinese Medicine Constitutions in Children with Pre-shortness and Establishment of a Risk Predictive Model

Objective To investigate traditional Chinese medicine (TCM) constitutions and influencing factors in preschool children with pre-shortness in Haidian District of Beijing, China, to establish a risk predictive model, and to provide a reference for the prevention and treatment of pre-shortness in children. Methods The methods of cluster sampling and questionnaire survey were used to select 1 612 preschool children in Haidian District of Beijing as subjects. The effect of the influencing factors for pre-shortness was expressed as odds ratio (OR) and its 95% confidence interval (CI). Stata 14.0 was used for statistical analysis, and R software was used to plot a nomogram model for risk prediction. Results The detection rate of pre-shortness was 14.0% among children. There was a significant difference in the distribution of Yin-deficiency constitution between the pre-shortness group and the normal body height group (P<0.05). The multivariate Logistic regression analysis showed that paternal body height (OR=0.90, 95% CI: 0.87-0.93, P=0.000), maternal body height (OR=0.89, 95% CI: 0.86-0.92, P=0.000), body length at birth (OR=0.92, 95% CI: 0.87-0.97, P<0.002), body weight at birth (OR=0.48, 95% CI: 0.36-0.65, P=0.000), duration of breastfeeding for >12 months (OR=1.51, 95% CI: 1.11-2.05, P=0.008), and Yin-deficiency constitution (OR=1.19, 95% CI: 1.01-1.39, P=0.038) were significant influencing factors for pre-shortness. A nomogram model for risk prediction was established based on the above significant influencing factors, with an index of concordance of 71.0 % (P<0.001).Conclusion Pre-shortness in children is the result of multiple factors such as inheritance, birth conditions, breastfeeding, and TCM constitution.