| 孙骊珠,凌艳萍,俞海国,樊志丹,黄丽娟.川崎病患儿并发冠状动脉损伤的危险因素及风险预测指标模型的评价与构建[J].,2023,(2):283-288 |
| 川崎病患儿并发冠状动脉损伤的危险因素及风险预测指标模型的评价与构建 |
| Evaluation and Construction of Risk Factors and Risk Predictors Indexes for Concomitant Coronary Artery Lesions in Children with Kawasaki Disease |
| 投稿时间：2022-06-26 修订日期：2022-07-21 |
| DOI：10.13241/j.cnki.pmb.2023.02.015 |
| 中文关键词: 川崎病 冠状动脉损伤 炎症 危险因素 预测模型 |
| 英文关键词: Kawasaki disease Coronary artery injury Inflammation Risk factors Predictive model |
| 基金项目:国家自然科学基金项目（81771762）；江苏省六大人才高峰项目（WSW-089） |
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| 中文摘要: |
| 摘要 目的：分析川崎病（KD）患儿并发冠状动脉损伤（CALs）的危险因素，并评价风险预测指标构建的模型价值。方法：选取2019年1月～2022年5月我院收治的100例KD患儿，根据是否合并CALs分为CALs组33例和非CALs组67例。采用单因素和多因素Logistic回归分析KD患儿并发CALs的影响因素。以多因素Logistic回归所保留的变量构建KD患儿并发CALs的预测模型。采用受试者工作特征（ROC）曲线分析构建的预测模型对KD患儿并发CALs的预测价值。结果：CALs组发热持续时间≥10 d、丙种球蛋白（IVIG）治疗延迟、IVIG无反应比例、中性粒细胞计数、红细胞沉降率（ESR）、C反应蛋白（CRP）、降钙素原（PCT）、N端脑利钠肽前体（NT-proBNP）、肌酸激酶MB（CK-MB）水平高于非CALs组（均P＜0.05）。多因素Logistic回归分析分析显示，发热持续时间≥10 d、IVIG治疗延迟、IVIG无反应、ESR、CRP、PCT、NT-proBNP、CK-MB为KD患儿并发CALs的危险因素（均P＜0.05）。以上述指标所构建KD患儿并发CALs的联合预测模型评估效能较高，其ROC-AUC（0.95CI）为0.891（0.813～0.950）。结论：发热持续时间、IVIG治疗延迟、IVIG无反应和ESR、CRP、PCT、NT-proBNP、CK-MB升高是KD患儿并发CALs的危险因素，根据风险预测指标构建的预测模型对KD患儿并发CALs的预测能效较好。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the risk factors for concomitant coronary artery lesions (CALs) in children with Kawasaki disease (KD), and to evaluate the value of models constructed for risk predictors. Methods: 100 children with KD who were admitted to our hospital from January 2019 to May 2022 were selected, and they were divided into 33 cases in the CALs group and 67 cases in the non-CALs group according to whether they were combined with CALs. Univariate and multivariate Logistic regression were used to analyze the influencing factors of concomitant CALs in children with KD. The prediction model of concomitant CALs in children with KD was established with the variables retained by Logistic regression. The predictive value of the prediction model constructed by receiver operating characteristic(ROC) curve analysis for concomitant CALs in children with KD. Results: The fever duration ≥ 10 d, the intravenous gamma globulin (IVIG) treatment delay, the proportion of IVIG non response, neutrophil count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), N-terminal pro B type natriuretic peptide (NT-proBNP) and creatine kinase MB (CK-MB) in CALs group were higher than those in non-CALs group (all P＜0.05). Multivariate Logistic regression analysis showed that fever duration ≥ 10 d, IVIG treatment delay, IVIG non response, ESR, CRP, PCT, NT-proBNP and CK-MB were the risk factors for concomitant CALs in children with KD (all P＜0.05). The evaluation efficiency of the combined prediction model for concomitant CALs in children with KD based on the above indicators was high, and the ROC-AUC (0.95CI) was 0.891 (0.813 ~ 0.950). Conclusion: Fever duration, IVIG treatment delay, IVIG non response and ESR, CRP, PCT, NT-proBNP and CK-MB increase are the risk factors of concomitant CALs in children with KD. The prediction model constructed according to the risk prediction indexes has good prediction efficiency for concomitant CALs in children with KD. |
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