川崎病患儿并发冠状动脉损伤的风险因素及列线图预测模型构建  

Risk factors for coronary artery lesions in children with Kawasaki disease and construction of a nomogram prediction model

作　　者：夏琨[1] 张勇[1] 周丹[1] XIA Kun;ZHANG Yong;ZHOU Dan(Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430019,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院,湖北武汉430019

出　　处：《华南预防医学》2024年第12期1136-1139,1144,共5页South China Journal of Preventive Medicine

基　　金：湖北省卫生健康委员会科研项目(WJ2021M019)。

摘　　要：目的 分析川崎病患儿并发冠状动脉损伤(CAL)的风险因素,构建川崎病并发CAL的列线图预测模型。方法 收集2021年1月至2023年12月武汉儿童医院心血管内科接受治疗的川崎病患儿220例,将患儿分组为分析组(172例)、验证组(48例)。分别通过单因素和多因素logistic回归模型分析影响川崎病并发CAL的风险因素,通过R软件构建川崎病并发CAL的列线图预测模型,并应用受试者工作特征曲线(ROC)及校准曲线验证预测模型。结果 分析组172例川崎病患儿中42例并发CAL,发生率为24.42%(42/172)。多因素logistic回归分析表明,红细胞分布密度(RDW)>13.3%(OR=3.838)、白细胞计数(WBC)>10×10^(9)/L(OR=2.363)、肌钙蛋白Ⅰ(cTnⅠ)>0.5μg/L(OR=3.644)及C反应蛋白(CRP)>50 mg/L(OR=4.614)是川崎病并发CAL的独立危险因素(均P<0.05)。列线图预测模型分析组曲线下面积(AUC)为0.851,验证组AUC为0.920,预测模型一致性较好,拟合优度检验分析组和验证组没有显著差异(P=0.573)。结论 构建由RDW、WBC、cTnⅠ、CRP组成的列线图预测模型或可帮助指导预防川崎病并发CAL。Objective To analyze the risk factors of coronary artery lesions(CAL)in children with Kawasaki dis⁃ease and construct a nomogram prediction model for Kawasaki disease concurrent CAL.Methods A total of 220 children with Kawasaki disease who received treatment in cardiovascular department of Wuhan Children's Hospital from January 2021 to December 2023 were collected and divided into an analysis group(172 cases)and a validation group(48 cases).By analyzing the risk factors of Kawasaki disease concurrent CAL through univariate analysis and multivariate logistic regres⁃sion analysis,a nomogram prediction model for Kawasaki disease concurrent CAL was constructed using R software,and the prediction model was validated using receiver operating characteristic(ROC)curves and calibration curves.Results In the analysis group of 172 Kawasaki disease cases,42 developed CAL,with an incidence rate of 24.42%(42/172).Multi⁃variate logistic regression analysis indicated that red blood cell distribution width(RDW)>13.3%(OR=3.838),white blood cell count(WBC)>10×10^(9)/L(OR=2.363),cardiac troponin-I(cTnI)>0.5μg/L(OR=3.644),and C-reactive protein(CRP)>50 mg/L(OR=4.614)were independent risk factors for Kawasaki disease concurrent CAL(all P<0.05).The area un⁃der the curve(AUC)of the nomogram prediction model for the analysis group was 0.851,and for the validation group,it was 0.920,indicating good consistency of the prediction model,with no significant difference in the goodness-of-fit test be⁃tween the analysis group and validation group(P=0.573).Conclusion A nomogram prediction model composed of RDW,WBC,cTnI,and CRP may help guide the prevention of Kawasaki disease concurrent CAL.

关 键 词：川崎病 冠状动脉损伤 风险因素 列线图模型 红细胞分布宽度 白细胞 肌钙蛋白Ⅰ 

分 类 号：R174[医药卫生—妇幼卫生保健]