影响川崎病病程的因素。
The factors affecting the disease course in Kawasaki disease.
机构信息
Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Department of Pediatric Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
出版信息
Rheumatol Int. 2019 Aug;39(8):1343-1349. doi: 10.1007/s00296-019-04336-2. Epub 2019 May 28.
The aim of this study was to review the characteristics of patients with Kawasaki disease (KD) from Turkey and to assess the performance of the Kobayashi score (KS), Harada score (HS), Formosa score (FS), Egami score (ES) and other parameters in predicting intravenous immunoglobulin (IVIG) resistance and coronary artery involvement (CAI) in the Turkish population. Patients who were diagnosed as being in the acute phase of KD at Hacettepe University Faculty of Medicine (Ankara, Turkey) between June 2007 and January 2016 reviewed retrospectively, and those between January 2016 and February 2018 reviewed prospectively, were included in this cohort study. A total of 100 patients with KD were included in this study. Statistical Package for Social Sciences for Windows 22.0 (SPSS Inc, Chicago, IL, USA) was used for statistical analysis. Eighty-five patients (85%) responded to IVIG treatment, whereas 15 (5 female, 10 male) were IVIG resistant. CAI was detected in echocardiography at diagnosis in 31 (31%) (9 female; 22 male) patients. For predicting IVIG resistance, KS, ES, FS, and HS had sensitivity of 82.1%, 26.7%, 30.8%, 69.2% and specificity of 35.7%, 94%, 51.2%, 45.8%, respectively. For the association with CAI occurrence, the sensitivities were 17.2%, 3.3%, 35.7%, 70.4% and the specificities were 78.5%, 88.4%, 49.3%, 49.3% for the aforementioned scores, respectively. The multivariate analysis showed white blood cell (WBC) count [Odd's ratio (OR) 4.1; 95% confidence interval (CI) 1.26-13.23; p = 0.019] and hematocrit (OR 3.8; 95% CI 1.15-12.4; p = 0.028), as independent predictors of CAI while gamma-glutamyl transferase (GGT) level (OR 5.7; 95% CI 1.73-27.51; p = 0.018) was detected as the only independent predictor of IVIG resistance. This is the first study from Turkey in KD to evaluate the association of the scoring systems for IVIG resistance and CAI. The risk scoring systems in KD did not predict the risk for IVIG resistance and were not associated with CAI in Turkish population.
本研究旨在回顾土耳其川崎病（KD）患者的特征，并评估小林评分（KS）、原田评分（HS）、台湾评分（FS）、江田评分（ES）和其他参数在预测土耳其人群中静脉注射免疫球蛋白（IVIG）抵抗和冠状动脉受累（CAI）中的表现。本队列研究回顾性纳入 2007 年 6 月至 2016 年 1 月在土耳其哈塞特佩大学医学院（安卡拉）被诊断为 KD 急性期的患者，前瞻性纳入 2016 年 1 月至 2018 年 2 月的患者。本研究共纳入 100 例 KD 患者。采用 Windows 22.0 版社会科学统计软件（SPSS Inc，芝加哥，IL，美国）进行统计分析。对于预测 IVIG 抵抗，KS、ES、FS 和 HS 的敏感性分别为 82.1%、26.7%、30.8%和 69.2%，特异性分别为 35.7%、94%、51.2%和 45.8%。对于与 CAI 发生的相关性，上述评分的敏感性分别为 17.2%、3.3%、35.7%、70.4%，特异性分别为 78.5%、88.4%、49.3%和 49.3%。多变量分析显示白细胞计数（OR 4.1；95%置信区间（CI）1.26-13.23；p=0.019）和红细胞压积（OR 3.8；95%CI 1.15-12.4；p=0.028）是 CAI 的独立预测因子，而γ-谷氨酰转肽酶（GGT）水平（OR 5.7；95%CI 1.73-27.51；p=0.018）是 IVIG 抵抗的唯一独立预测因子。这是土耳其 KD 中评估 IVIG 抵抗和 CAI 评分系统相关性的第一项研究。KD 中的风险评分系统不能预测 IVIG 抵抗的风险，也与土耳其人群中的 CAI 无关。
Zotero 插件