川崎病儿童冠脉病变的影响因素分析  

Influencing factors of coronary artery lesions in children with Kawasaki disease

作　　者：刘翠 刘小红[1] 吴岳[2] 刘丽[1] LIU Cui;LIU Xiaohong;WU Yue;LIU Li(Department of Pediatrics,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of Cardiovascular Medicine,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院儿科,陕西西安710061 [2]西安交通大学第一附属医院心血管内科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2022年第6期845-849,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家重点研发计划(No.2019YFA0802300)。

摘　　要：目的研究川崎病(KD)患儿血液来源指标中与冠状动脉病变相关的影响因素。方法回顾性分析2015年1月1日至2019年12月31日我院儿科收治的KD确诊患儿的临床资料,采用基线资料比较、多因素Logistic回归分析比较冠脉病变(CAL)组和无冠脉病变(nCAL)组间的血液来源指标的差异,并绘制受试者工作特征(ROC)曲线。结果CAL组和nCAL组之间的性别、红细胞沉降率(ESR)、淋巴细胞计数(L#)、红细胞分布宽度(RDW)有统计学差异(P<0.05);其中男性、较低的ESR、较低的L#、较高的RDW是CAL的独立危险因素,OR值及其95%置信区间(95%CI)分别为0.279(0.117,0.669)、0.973(0.955,0.992)、0.675(0.513,0.889)、2.433(1.313,4.506);RDW预测CAL的敏感度为37.3%,特异性为86.4%,最佳截断值为13.45%,曲线下面积(AUC)为0.616,95%CI为(0.514,0.718),P<0.05,ESR和L#对CAL没有预测价值。结论川崎病儿童的血液来源指标包括血常规和炎性指标(尤其是RDW)对冠脉病变有一定的预测价值,可结合心动超声共同评估疾病进展。Objective To study the influencing factors of blood source indicators related to coronary artery lesions in children with Kawasaki disease(KD).Methods Clinical data of children diagnosed with KD admitted to our hospital from January 1,2015 to December 31,2019 were retrospectively analyzed.Baseline data comparison and multivariate Logistic regression analysis were used to compare the differences in blood source indicators between the coronary artery lesion(CAL)group and the non-coronary artery lesion(nCAL)group,and the receiver operating characteristic(ROC)curve was drawn.Results There were significant differences in sex,erythrocyte sedimentation rate(ESR),lymphocyte count(L#)and red blood cell distribution width(RDW)between the CAL group and the nCAL group(P<0.05).Male,lower ESR,lower L#,and higher RDW were independent risk factors for CAL.OR values and their 95%confidence intervals(95%CI)were 0.279(0.117,0.669),0.973(0.955,0.992),0.675(0.513,0.889),and 2.433(1.313,4.506),respectively.The sensitivity and specificity of RDW for predicting CAL were 37.3%and 86.4%,the best cutoff value was 13.45%,the area under curve(AUC)was 0.616,and 95%CI was(0.514,0.718)(P<0.05).ESR and L#had no predictive value for CAL.Conclusion Blood source indicators of children with Kawasaki disease,including blood routine and inflammatory indicators,especially RDW,have certain predictive value for coronary artery lesions.They can be combined with echocardiography to evaluate disease progression.

关 键 词：川崎病 冠状动脉病变 危险因素 红细胞分布宽度 

分 类 号：R725.4[医药卫生—儿科]