川崎病患儿冠状动脉扩张或动脉瘤的原田评分阴性预测值：一项横断面研究。
The Negative Predictive Value of Harada Scoring for Coronary Artery Dilatation or Aneurysm in Children with Kawasaki Disease: A Cross-sectional Study.
机构信息
Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
出版信息
Iran J Med Sci. 2022 Jul;47(4):379-384. doi: 10.30476/IJMS.2021.90005.2079.
BACKGROUND
The most common cause of coronary artery aneurysms in children is Kawasaki disease (KD). One of the risk ratings used to predict coronary artery aneurysms is the Harada score. This study aims to assess the negative predictive value (NPV) of Harada scoring in children with KD.
METHODS
This cross-sectional study was conducted in Mashhad (Iran) from January 2014 to December 2017. The Harada score was generated for each patient using demographic, laboratory, and echocardiography data retrieved from their medical records. The patients were divided into typical and atypical cases, and the sensitivity, specificity, positive predictive value (PPV), and NPV were calculated. The Chi square test, independent test, Mann-Whitney U test, and Fisher exact test were used to analyze the data in SPSS software (version 23.0). P≤0.05 was considered statistically significant.
RESULTS
The study involved 168 individuals with a mean age of 29.91±19.52 months, including 103 typical and 65 atypical cases. Regarding cardiac complications, the atypical group had a significantly greater rate of coronary artery tapering (P=0.030). Out of 101 patients with cardiac complications, the Harada score was positive in 57 cases, while it was falsely negative in the remaining 44 patients. The calculated sensitivity, specificity, PPV, and NPV were 56.44%, 53.73%, 64.77%, and 45%, respectively.
CONCLUSION
The findings revealed that the Harada scoring is ineffective in detecting coronary artery aneurysms or dilation in KD patients.
背景
儿童冠状动脉瘤最常见的原因是川崎病（KD）。用于预测冠状动脉瘤的风险评分之一是原田评分。本研究旨在评估川崎病患儿原田评分的阴性预测值（NPV）。
方法
本横断面研究于 2014 年 1 月至 2017 年 12 月在伊朗马什哈德进行。根据从病历中获取的人口统计学、实验室和超声心动图数据，为每位患者生成原田评分。将患者分为典型和非典型病例，并计算敏感性、特异性、阳性预测值（PPV）和 NPV。使用 SPSS 软件（版本 23.0）中的卡方检验、独立 t 检验、Mann-Whitney U 检验和 Fisher 确切检验分析数据。P≤0.05 被认为具有统计学意义。
结果
本研究共纳入 168 名平均年龄为 29.91±19.52 个月的患者，其中 103 例为典型病例，65 例为非典型病例。关于心脏并发症，非典型组冠状动脉变细的发生率显著更高（P=0.030）。在 101 例有心脏并发症的患者中，57 例原田评分阳性，而其余 44 例原田评分假阴性。计算出的敏感性、特异性、PPV 和 NPV 分别为 56.44%、53.73%、64.77%和 45%。
结论
研究结果表明，原田评分无法有效检测 KD 患者的冠状动脉瘤或扩张。
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