低密度脂蛋白胆固醇对川崎病患儿丙种球蛋白耐药的预测价值  

The predictive value of serum LDL-C for gamma immunoglobulin resistance in children with Kawasaki disease

作　　者：吴丽平 青秀 李刚 刘东 刘斌 WU Li-ping;QING Xiu;LI Gang;LIU Dong;LIU Bin(Department of Pediatrics,The Affiliated Hospital of Southwest Medical University,Sichuan Clinical Research Center for Birth Defects,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院儿科,四川省出生缺陷临床医学研究中心,四川泸州646000

出　　处：《实用医院临床杂志》2022年第2期65-68,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨低密度脂蛋白胆固醇(LDL-C)对川崎病(KD)患儿静脉注射人免疫球蛋白(intravenous immunoglobulin,IVIG)耐药的预测价值。方法回顾性收集224例KD患儿IVIG治疗前的血脂、血常规、血清白蛋白(ALB)和电解质等检测结果,并计算中性粒细胞计数与淋巴细胞计数比值(NLR)、血小板计数与淋巴细胞计数比值(PLR)和系统性免疫-炎症指数(SII)。分别通过ROC曲线和多因素Logistic回归确定各变量对KD患儿IVIG耐药的预测价值及影响IVIG耐药的危险因素。结果相比IVIG敏感组,IVIG耐药组的中性粒细胞比例(N-R)、NLR值较高,而血小板计数(PLT)、ALB、血钠(Na)、血钾(K)、总胆固醇(TC)及LDL-C均较低,差异有统计学意义(P<0.05);LDL-C预测IVIG耐药的ROC曲线下面积(AUC)与PLT相同,低于NLR和K,但高于N-R、ALB、Na和TC;多因素Logistic回归分析显示LDL-C是影响KD患儿IVIG耐药的危险因素。结论LDL-C可作为KD患儿IVIG耐药的预测指标。Objective To explore the predictive value of low density lipoprotein cholesterol(LDL-C)for intravenous immunoglobulin(IVIG)resistance in children with Kawasaki disease(KD).Methods Clinical data of 224 children with KD before IVIG treatment were collected retrospectively.The data included serum lipid,blood routine,serum albumin(ALB)and blood electrolyte index.Neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and systemic immune-inflammatory index(SII)were calculated.ROC curve analysis and logistic regression analysis were used to determine the diagnostic value of each indicator for IVIG resistance in children with KD and the risk factors of IVIG resistance.Results Compared with the IVIG sensitive group,the IVIG resistant group had higher neutrophil ratio(N-R)and NLR values,while platelet count(PLT),ALB,serum sodium(Na),serum potassium(K),total cholesterol(TC),and LDL-C levels were lower(P<0.05).The area under the curve(AUC)of ROC curve for LDL-C to predict IVIG resistance was equal to that of PLT,lower than that of NLR and K,but higher than that of N-R,ALB,Na and TC.Multivariate logistic regression analysis showed that LDL-C was a risk factor for IVIG resistance in children with KD.Conclusion LDL-C can be used as a predictor of IVIG resistance in children with KD.

关 键 词：低密度脂蛋白胆固醇 川崎病 静脉注射人免疫球蛋白耐药 

分 类 号：R725.4[医药卫生—儿科]