中国当代儿科杂志2024，Vol.26Issue(5)：461-468,8.DOI:10.7499/j.issn.1008-8830.2309103
5岁以上川崎病儿童合并冠状动脉病变的预测指标与风险模型构建
Predictive indicators and risk model construction for coronary artery lesions in Kawasaki disease children over 5 years old
摘要
Abstract
Objective To study predictive indicators for coronary artery lesions(CAL)and construct a risk predic-tion model for CAL in Kawasaki disease(KD)children over 5 years old.Methods A retrospective analysis of KD children over 5 years old at Wuhan Children's Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2018 to January 2023 was conducted.Among them,47 cases were complicated with CAL,and 178 cases were not.Multivariate logistic regression analysis was used to explore predictive indicators for CAL in KD children over 5 years old and construct a risk prediction model.The receiver operating characteristic curve was used to evaluate the effectiveness of the prediction model.Finally,the Framingham risk scoring method was used to quantify the predictive indicators,calculate the contribution of each indicator to the prediction of CAL in KD children over 5 years old,and construct a risk prediction scoring model.Results The multivariate logistic regression analysis showed that the duration of fever before the initial intravenous immunoglobulin(IVIG)treatment(OR=1.374,95％CI:1.117-1.689),levels of hypersensitive C-reactive protein(hs-CRP;OR=1.008,95％CI:1.001-1.015),and serum ferritin levels(OR=1.002,95％CI:1.001-1.003)were predictive indicators for CAL in KD children over 5 years old.The optimal cutoff values for predicting CAL were:duration of fever before initial IVIG treatment of 6.5 days(AUC=0.654,95％CI:0.565-0.744),hs-CRP of 110.50 mg/L(AUC=0.686,95％CI:0.597-0.774),and ferritin of 313.62 mg/L(AUC=0.724,95％CI:0.642-0.805).According to the Framingham risk scoring method,the low,medium,and high-risk states of CAL occur-rence were defined as probabilities of＜10％,10％-20％,and＞20％,respectively,with corresponding scores of 0-4 points,5-6 points,and ≥7 points.Conclusions In KD children over 5 years old,those with a longer duration of fever before initial IVIG treatment,higher levels of hs-CRP,or elevated serum ferritin levels are more likely to develop CAL.关键词
川崎病/冠状动脉病变/预测指标/风险预测模型/儿童Key words
Kawasaki disease/Coronary artery lesion/Predictive indicator/Risk prediction model/Child引用本文复制引用
张华勇,张勇..5岁以上川崎病儿童合并冠状动脉病变的预测指标与风险模型构建[J].中国当代儿科杂志,2024,26(5):461-468,8.基金项目
武汉儿童医院临床医学研究项目(2022FE011). （2022FE011）
