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[儿童川崎病继发冠状动脉病变的危险因素]

[Risk factors for coronary artery lesions secondary to Kawasaki disease in children].

作者信息

Deng Yong-Chao, Wang Xun, Tang Xi-Chun, Huang Cai-Zhi, Yang Juan, Mo Li-Ya

机构信息

Department of Clinical Laboratory of Hunan Childrenγs Hospital, Changsha 410007, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2015 Sep;17(9):927-31.

PMID:26412172
Abstract

OBJECTIVE

To explore the risk factors for coronary artery lesions (CAL) secondary to Kawasaki disease (KD) in children.

METHODS

The medical data of 895 children with KD were retrospectively reviewed. The patients were classified into two groups according to the presence of CAL: CAL (n=284) and control (n=611). The clinical and laboratory indices were compared between the two groups. The risk factors for the development of CAL in children with KD were identified by multiple logistic regression analysis.

RESULTS

Male gender (OR=1.712), occurrence of non-CAL complications (OR=2.028), atypical KD (OR=3.655), intravenous immunoglobulin (IVIG) resistance (OR=2.912), more than 5 days of fever duration before IVIG treatment (OR=1.350), and increased serum procalcitonin (PCT) level (OR=1.068) were the independent risk factors for the development of CAL in children with KD (P<0.05), whereas increased serum albumin (Alb) level was a protective factor (OR=0.931, P<0.05). The areas under the receiver operating characteristic curve of serum PCT and ALB for prediction of the development of CAL in children with KD were 0.631 and 0.558, respectively.

CONCLUSIONS

Male gender, atypical KD, occurrence of other non-CAL complications, long duration of fever and IVIG resistance are associated with an increased risk for CAL in children with KD. Serum PCT and ALB have little value in the prediction of CAL in children with KD.

摘要

目的

探讨儿童川崎病(KD)继发冠状动脉病变(CAL)的危险因素。

方法

回顾性分析895例KD患儿的医学资料。根据是否存在CAL将患者分为两组:CAL组(n = 284)和对照组(n = 611)。比较两组的临床和实验室指标。通过多因素logistic回归分析确定KD患儿发生CAL的危险因素。

结果

男性(OR = 1.712)、非CAL并发症的发生(OR = 2.028)、非典型KD(OR = 3.655)、静脉注射免疫球蛋白(IVIG)抵抗(OR = 2.912)、IVIG治疗前发热持续时间超过5天(OR = 1.350)以及血清降钙素原(PCT)水平升高(OR = 1.068)是KD患儿发生CAL的独立危险因素(P < 0.05),而血清白蛋白(Alb)水平升高是保护因素(OR = 0.931,P < 0.05)。血清PCT和ALB预测KD患儿发生CAL的受试者工作特征曲线下面积分别为0.631和0.558。

结论

男性、非典型KD、其他非CAL并发症的发生、发热持续时间长和IVIG抵抗与KD患儿发生CAL的风险增加相关。血清PCT和ALB对KD患儿CAL的预测价值不大。

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