基于Z值回归模型诊断儿童冠状动脉病变的研究  

Diagnosis of coronary artery lesions in children based on Z-score regression model

作　　者：王永 蒋佳颖 邓燕[3] 李波[1] 帅平[4] 胡小平[1] 张银滟 吴寒 叶露薇 彭茜[1] WANG Yong;JIANG Jia-Ying;DENG Yan;LI Bo;SHUAI Ping;HU Xiao-Ping;ZHANG Yin-Yan;WU Han;YE Lu-Wei;PENG Qian(Department of Pediatrics,Sichuan Academy of Medical Science-Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院儿科,四川成都610072 [2]成都中医药大学,四川成都610075 [3]四川省医学科学院·四川省人民医院超声心脏电生理与生物力学四川省重点实验室,四川成都610072 [4]四川省医学科学院·四川省人民医院健康管理中心,四川成都610072

出　　处：《中国当代儿科杂志》2025年第2期176-183,共8页Chinese Journal of Contemporary Pediatrics

基　　金：四川省人民医院科研基金资助项目(2021ZX07);四川省卫生与计生委课题(150197)。

摘　　要：目的构建四川地区儿童超声心动图冠状动脉内径Z值回归模型,建立Z值计算公式。方法选取2020年1月—2022年12月在四川省人民医院体检的744例健康儿童为建模组,选取2018年1月—2022年12月在该院诊断为川崎病的251例患儿为验证组,运用Pearson相关分析对冠状动脉内径值与年龄、身高、体重、体表面积进行分析,通过函数转换构建回归模型,找出最佳回归模型并建立Z值计算公式,并对模型进行验证。结果Pearson相关分析显示,左冠状动脉主干、左前降支、左回旋支、右冠状动脉内径值与体表面积相关系数分别为0.815、0.793、0.704、0.802(P<0.05)。在构建回归模型时,幂函数回归模型表现出最佳效果,因此选用幂函数模型作为建立Z值计算公式的最佳模型。基于此Z值计算公式,发现冠状动脉病变的检出率为21.5%(54/251),这一比例高于基于冠状动脉内径绝对值标准的检出率。特别是在左前降支和左回旋支中,使用该Z值计算公式获得的冠状动脉病变检出率高于既往的经典Z值计算公式。结论基于幂函数回归模型建立的Z值计算公式,冠状动脉病变的检出率较高,可为临床医生,特别是针对川崎病患儿冠状动脉病变的评估提供有力的参考依据。Objective To construct a Z-score regression model for coronary artery diameter based on echocardiographic data from children in Sichuan Province and to establish a Z-score calculation formula.Methods A total of 744 healthy children who underwent physical examinations at Sichuan Provincial People's Hospital from January 2020 to December 2022 were selected as the modeling group,while 251 children diagnosed with Kawasaki disease at the same hospital from January 2018 to December 2022 were selected as the validation group.Pearson correlation analysis was conducted to analyze the relationships between coronary artery diameter values and age,height,weight,and body surface area.A regression model was constructed using function transformation to identify the optimal regression model and establish the Z-score calculation formula,which was then validated.Results The Pearson correlation analysis showed that the correlation coefficients for the diameters of the left main coronary artery,left anterior descending artery,left circumflex artery,and right coronary artery with body surface area were 0.815,0.793,0.704,and 0.802,respectively(P<0.05).Among the constructed regression models,the power function regression model demonstrated the best performance and was therefore chosen as the optimal model for establishing the Z-score calculation formula.Based on this Z-score calculation formula,the detection rate of coronary artery lesions was found to be 21.5%(54/251),which was higher than the detection rate based on absolute values of coronary artery diameter.Notably,in the left anterior descending and left circumflex arteries,the detection rate of coronary artery lesions using this Z-score calculation formula was higher than that of previous classic Z-score calculation formulas.Conclusions The Z-score calculation formula established based on the power function regression model has a higher detection rate for coronary artery lesions,providing a strong reference for clinicians,particularly in assessing coronary artery lesions in child

关 键 词：川崎病 冠状动脉病变 冠状动脉 Z值 超声心动图 儿童 

分 类 号：R725.4[医药卫生—儿科]