川崎病患儿并发冠状动脉瘤相关危险因素分析  

Risk Factors Related to Coronary Artery Aneurysm in Children with Kawasaki Disease

作　　者：王金慎[1] 马磊 布春青[2] 韩月芹[1] 秦道刚[1] WANG Jinshen;MA Lei;BU Chunqing;HAN Yueqin;QIN Daogang(Department of Pediatrics,Liaocheng People’s Hospital,Liaocheng 252000,Shandong,China;Department of Radiology,Liaocheng People’s Hospital,Liaocheng 252000,Shandong,China)

机构地区：[1]聊城市人民医院儿内科,山东聊城252000 [2]聊城市人民医院磁共振室,山东聊城252000

出　　处：《现代诊断与治疗》2023年第8期1123-1126,共4页Modern Diagnosis and Treatment

摘　　要：目的 探讨川崎病患儿并发冠状动脉瘤的相关危险因素及其预测价值。方法 回顾性分析2019年1月至2022年4月在聊城市人民医院儿科住院的218例川崎病患儿的临床资料,包括性别、年龄等共30项临床指标;根据冠状动脉扩张情况,分为冠状动脉瘤组及非冠状动脉瘤组,比较两组之间相关指标;多变量Logistic回归分析冠状动脉瘤的独立危险因素,受试者工作特征曲线评估该因素对川崎病冠状动脉瘤的预测价值。结果 218例川崎病患儿有39例存在冠状动脉瘤,其中中型冠状动脉瘤5例,小型冠状动脉瘤34例;33例存在丙种球蛋白耐药。冠状动脉瘤组患儿与非冠状动脉瘤组患儿在年龄、是否丙种球蛋白耐药、白蛋白水平、血钠水平等方面比较存在显著差异(P<0.05)。多变量Logistic回归显示低钠和丙种球蛋白耐药是川崎病患儿并发冠状动脉瘤的独立危险因素(P<0.05);受试者工作特征曲线确定血钠最佳预测值132.05,灵敏度0.804,特异度0.41,曲线下面积为0.608;血钠、丙种球蛋白耐药联合预测KD相关CAA的曲线下面积为0.642。结论 血钠<132.05 mmol/L、丙种球蛋白耐药是KD并发CAA的独立危险因素,对于预测川崎病CAA有一定价值。Objectives To investigate the risk factors and predictive value for Coronary Artery Aneurysm(CAA) in children with Kawasaki Disease(KD).Methods The clinical data of 218 children with KD hospitalized in the Department of Pediatrics of Liaocheng People's Hospital from January 2019 to April 2022 were retrospectively analyzed,including indexes such as gender and age.According to the status of coronary artery dilatation,the patients were divided into CAA group and non-CAA group,and the relevant indexes between the two groups were compared.Multivariate Logistic regression was used to analyze the independent risk factors of CAA,and ROC was used to evaluate the predictive value of these factor for coronary artery aneurysm in KD.Results Among the 218 KD children,39 cases were CAA,including 5 cases of medium-sized CAA and 34 cases of small-sized CAA,and there were 33 cases had IVIG resistance.There were significant differences in age,IVIG resistance,albumin level and serum sodium level between the two groups(P<0.05).Multivariate Logistic regression showed that hyponatremia and IVIG resistance were independent risk factors for CAA in children with KD.The ROC curve showed that the best predictive value of serum sodium was 132.05 mmol/L,with the sensitivity and specificity being 0.804 and 0.41,respectively.The area under the curve was 0.608,and the area under the curve of the combination of serum sodium and IVIG resistance for predicting KD-related CAA was 0.642.Conclusions Serum sodium<132.05 mmol/L and IVIG resistance are independent risk factors for KD complicated with CAA,which has certain predictive value for CAA in KD.

关 键 词：川崎病 冠状动脉瘤 低钠血症 丙种球蛋白耐药 

分 类 号：R725.5[医药卫生—儿科]