川东北地区川崎病患者并发冠状动脉病变的预测因素  

Analysis of predictive factors of coronary artery lesions in patients with Kawasaki disease in Northeast Sichuan

作　　者：何永 莫国梁[1] 康迁[1] 皮光环 张家燕[1] 邓斌[1] HE Yong;MO Guoliang;KANG Qian;PI Guanghuan;ZHANG Jiayan;DENG Bin(The Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China;Sichuan Provincial Maternity and Child Health Care Hospital,Chengdu 610000,China)

机构地区：[1]川北医学院附属医院,四川南充637000 [2]四川省妇幼保健院,四川成都610000

出　　处：《西部医学》2024年第2期286-290,共5页Medical Journal of West China

基　　金：2021年川北医学院校级科研发展计划项目(CBY21-QA45)。

摘　　要：目的 探讨川东北地区川崎病(KD)并发冠状动脉病变(CAL)的预测因素。方法 收集川北医学院附属医院2015年1月-2018年12月收治的279例川崎病患儿临床资料行回顾性分析。将其分为冠脉损伤组(79例,CAL组)和无冠脉损伤组(200例,NCAL组),对比两组患儿临床数据,采用Logistic回归分析KD并发CAL的独立危险因素,构建ROC曲线以确定危险因素的最佳预测界值及敏感度、特异度。结果 79例(28.32%)KD患儿伴发CAL。CAL组持续发热时间较NCAL组更长,CAL组中发热>10 d的患儿比例较NCAL组更高(均P<0.05)。CAL组的心包积液发生率较NCAL组更高(P<0.05)。CAL组PLT计数、纤维蛋白原(FIB)浓度显著高于NCAL组(均P<0.05)。多因素分析结果显示,FIB浓度增加、PLT计数增加、心包积液是KD伴发CAL的独立危险因素。通过ROC曲线分析显示FIB>4.54 g/L预测KD伴发CAL的灵敏度和特异度分别为80.0%、63.6%;PLT>459×10^(9)/L预测KD伴发CAL的灵敏度和特异度分别为44.2%、86.5%。结论 KD患儿急性期PLT计数、FIB浓度、心包积液对于预测KD伴发CAL具有一定的临床价值。Objective To explore the predictive factors of coronary artery lesions in patients with Kawasaki disease in Northeast Sichuan.Methods The data of 279 patients with Kawasaki disease diagnosed in the Affiliated Hospital of North Sichuan Medical College from January 2015 to December 2018 were analyzed retrospectively.According to the existence of coronary artery lesions,the patients were divided into two groups:coronary artery lesions group(CAL group)and no coronary artery lesions group(NCAL group).The clinical data of the two groups were compared,the independent risk factors of KD complicated with CAL were analyzed by logistic regression,and the ROC curve was constructed to determine the best predictive limit,sensitivity and specificity of risk factors.Results 79 cases(28.32%)had coronary artery lesions.Univariate analysis showed that Fever time is more than 10 days,FIB concentration,PLT count,pericardial effusion,the total duration of fever during the course of the disease were the risk factors for KD complicated with CAL.Multivariate Logistic regression analysis showed that increased FIB concentration,increased PLT count,pericardial effusion were independent risk factors for KD with CAL.ROC curve analysis showed that the sensitivity and specificity of FIB>4.54g/L in predicting KD associated CAL were 80.0%and 63.6%,the sensitivity and specificity of PLT>459×10^(9)/L in predicting KD associated CAL were 44.2%and 86.5%.Conclusion PLT count,FIB concentration and pericardial effusion have certain clinical value in predicting KD with CAL.

关 键 词：川崎病 冠状动脉病变 危险因素 心包积液 血浆纤维蛋白原 

分 类 号：R725.4[医药卫生—儿科]