| 王春笛,赵 丽,秦 雯,孔 菲,魏碧琼.川崎病患儿并发冠状动脉损伤的危险因素及预测模型的构建与评价[J].,2023,(19):3636-3641 |
| 川崎病患儿并发冠状动脉损伤的危险因素及预测模型的构建与评价 |
| Risk Factors of Coronary Artery Lesion in Children with Kawasaki Disease and Construction and Evaluation of the Predictive Model |
| 投稿时间：2023-03-03 修订日期：2023-03-24 |
| DOI：10.13241/j.cnki.pmb.2023.19.007 |
| 中文关键词: 川崎病 冠状动脉损伤 危险因素 预测模型 构建 评价 |
| 英文关键词: Kawasaki disease Coronary artery lesion Risk factors Predictive model Construction Evaluation |
| 基金项目:江苏省卫生计生委科研基金项目（Q20180617） |
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| 中文摘要: |
| 摘要 目的：分析川崎病患儿并发冠状动脉损伤（CAL）的危险因素，并构建和评价川崎病患儿并发CAL的预测模型。方法：选取2019年1月～2022年5月我院收治的342例川崎病患儿，根据是否并发CAL分为CAL组和非CAL组。收集所有患儿临床资料，采用单因素和多因素Logistic回归分析川崎病患儿并发CAL的影响因素，并构建预测模型，H-L检验和受试者工作特征（ROC）曲线检验预测模型拟合优度和对川崎病患儿并发CAL的预测价值。结果：342例川崎病患儿CAL发生率为16.67％（57/342）。单因素分析显示，CAL组发热持续时间≥10 d、静脉注射免疫球蛋白（IVIG）治疗延迟、IVIG无反应比例和单核细胞比例（MO％）、嗜酸性粒细胞比例（EO％）、C反应蛋白（CRP）、红细胞沉降率（ESR）、降钙素原（PCT）、心肌肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK-MB）水平高于非CAL组（P均＜0.05）。多因素Logistic回归分析显示，发热持续时间≥10 d、IVIG治疗延迟、IVIG无反应和MO％、CRP、ESR、PCT、cTnI升高为川崎病患儿并发CAL的独立危险因素（P均＜0.05）。H-L检验川崎病患儿并发CAL的预测模型拟合效果良好。ROC曲线分析显示，该模型预测川崎病患儿并发CAL的曲线下面积（AUC）为0.911（95％CI：0.876～0.939）。结论：发热持续时间≥10 d、IVIG治疗延迟、IVIG无反应和MO％、CRP、ESR、PCT、cTnI升高为川崎病患儿并发CAL的危险因素，根据危险因素构建的川崎病患儿并发CAL预测模型价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the risk factors for concomitant coronary artery lesion (CAL) in children with Kawasaki disease, and to construct and evaluate a predictive model for concomitant CAL in children with Kawasaki disease. Methods: 342 children with Kawasaki disease who were admitted to our hospital from January 2019 to May 2022 were selected, and they were divided into CAL group and non CAL group according to whether they have concomitant CAL. The clinical data of all children were collected. The influencing factors of children with Kawasaki disease concomitant CAL were analyzed by univariate and multivariate Logistic regression, and a predictive model was constructed. The goodness of fit of the predictive model and the predictive value of Kawasaki disease concomitant CAL were tested by H-L test and receiver operating characteristic (ROC) curve. Results: The incidence of CAL in 342 children with Kawasaki disease was 16.67% (57/342). Univariate analysis showed that the duration of fever greater than or equal to 10 d, delayed intravenous gamma globulin (IVIG) treatment, IVIG non-response ratio and monocyte ％(MO%), eosinophil ％(EO%), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB) levels in the CAL group were higher than those in the non-CAL group (all P<0.05). Multivariate Logistic regression analysis showed that duration of fever greater than or equal to 10d, delayed IVIG treatment, IVIG non response and increased MO%, CRP, ESR, PCT, cTnI were independent risk factors for children with Kawasaki disease concomitant CAL (all P<0.05). The predictive model of children with Kawasaki disease concomitant CAL by H-L test had a good fitting effect. ROC curve analysis showed that the area under curve(AUC) of children with Kawasaki disease concomitant CAL predicted by this model was 0.911 (95% CI: 0.876～0.939). Conclusion: The duration of fever greater than or equal to 10d, delayed IVIG treatment, IVIG non response and MO%, CRP, ESR, PCT and cTnI are risk factors for the children with Kawasaki disease concomitant CAL. The predictive model of the children with Kawasaki disease concomitant CAL based on risk factors is of high value. |
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