Xu Haiyan, Fu Songling, Wang Wei, Zhang Qing, Hu Jian, Gao Lichao, Zhu Weihua, Gong Fangqi
Children's Hospital,Zhejiang University School of Medicine,Hangzhou,PR China.
Cardiol Young. 2016 Aug;26(6):1151-7. doi: 10.1017/S1047951115002140. Epub 2015 Oct 5.
Recent studies have shown that elevated red blood cell distribution width is associated with poor outcome in cardiovascular diseases. In order to assess the predictive value of red blood cell distribution width, before treatment with intravenous immunoglobulins, for coronary artery lesions in patient with Kawasaki disease, we compared 83 patients with coronary artery lesions and 339 patients without coronary artery lesions before treatment with intravenous immunoglobulin. Clinical, echocardiographic, and biochemical values were evaluated along with red blood cell distribution width. A total of 422 consecutive patients with Kawasaki disease were enrolled into our study. According to receiver operating characteristic curve analysis, the optimal red blood cell distribution width cut-off value for predicting coronary artery lesions was 14.55% (area under the curve was 0.721; p=0.000); eighty-three patients (19.7%) had coronary artery lesions, and 70% of the patients with coronary artery lesions had red blood cell distribution width level >14.55%. Logistic regression analysis revealed that fever duration >14 days (odds ratio was 3.42, 95% confidence interval was 1.27-9.22; p=0.015), intravenous immunoglobulin resistance (odds ratio was 2.33, 95% confidence interval was 1.02-5.29; p=0.04), and red blood cell distribution width >14.55% (odds ratio was 3.49, 95% confidence interval was 2.01-6.05; p=0.000) were independent predictors of coronary artery lesions in patients with Kawasaki disease. In Conclusion, red blood cell distribution width may be helpful for predicting coronary artery lesions in patients with Kawasaki disease.
近期研究表明，红细胞分布宽度升高与心血管疾病的不良预后相关。为了评估静脉注射免疫球蛋白治疗前红细胞分布宽度对川崎病患者冠状动脉病变的预测价值，我们比较了83例有冠状动脉病变的患者和339例静脉注射免疫球蛋白治疗前无冠状动脉病变的患者。对临床、超声心动图和生化指标以及红细胞分布宽度进行了评估。共有422例连续的川崎病患者纳入我们的研究。根据受试者工作特征曲线分析，预测冠状动脉病变的最佳红细胞分布宽度截断值为14.55%（曲线下面积为0.721；p = 0.000）；83例患者（19.7%）有冠状动脉病变，70%有冠状动脉病变的患者红细胞分布宽度水平>14.55%。逻辑回归分析显示，发热持续时间>14天（比值比为3.42，95%置信区间为1.27 - 9.22；p = 0.015）、静脉注射免疫球蛋白抵抗（比值比为2.33，95%置信区间为1.02 - 5.29；p = 0.04）以及红细胞分布宽度>14.55%（比值比为3.49，95%置信区间为2.01 - 6.05；p = 0.000）是川崎病患者冠状动脉病变的独立预测因素。总之，红细胞分布宽度可能有助于预测川崎病患者的冠状动脉病变。
