基于 C 反应蛋白水平预测川崎病患儿冠状动脉病变：一项回顾性队列研究。
Prediction of coronary artery lesions based on C-reactive protein levels in children with Kawasaki Disease: a retrospective cohort study.
机构信息
University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Department of Pharmacy, Chengdu, China.
University of Electronic Science and Technology of China, School of Medicine, Chengdu, China; University of Electronic Science and Technology of China, School of Medicine, Chengdu Women's and Children's Central Hospital, Office of Good Clinical Practice, Chengdu, China.
出版信息
J Pediatr (Rio J). 2023 Jul-Aug;99(4):406-412. doi: 10.1016/j.jped.2023.02.005. Epub 2023 Mar 25.
OBJECTIVE
Since coronary artery lesions (CALs) are the most severe complication of Kawasaki disease (KD), clinically speaking, early prediction of CALs is crucial. The authors aimed to investigate the predictive value of C-reactive protein (CRP) in predicting CALs in KD patients.
METHODS
KD patients were divided into the CALs group and the non-CALs group. The clinical and laboratory parameters were collected and compared. Multivariate logistic regression analysis was used to determine the independent risk factors of CALs. The receiver operating characteristic curve was applied to determine the optimal cut-off value.
RESULTS
851 KD patients who met the inclusion criteria were studied, including 206 in the CALs group and 645 in the non-CALs group. Children in the CALs group had significantly higher CRP levels than the non-CALs group (p < 0.05). Multivariable logistic regression analysis showed that incomplete KD, male, lower hemoglobin, and higher CRP were independent risk factors for predicting CAL (all p < 0.05). The optimal cut-off value of initial serum CRP for predicting CALs was 105.5 mg/L, with a sensitivity of 47.57% and a specificity of 69.61%. In addition, KD patients with high CRP (≥105.5 mg/L) had a higher occurrence of CALs than those with low CRP (<105.5 mg/L) (33% vs 19%, p < 0.001).
CONCLUSION
The incidence of CALs was significantly higher in patients with high CRP. CRP is an independent risk factor for CALs formation and may be useful for predicting CALs in KD patients.
目的
由于冠状动脉病变（CALs）是川崎病（KD）最严重的并发症，因此从临床角度来看，早期预测 CALs 至关重要。作者旨在探讨 C 反应蛋白（CRP）在预测 KD 患者 CALs 中的预测价值。
方法
将 KD 患者分为 CALs 组和非-CALs 组。收集并比较了临床和实验室参数。采用多变量逻辑回归分析确定 CALs 的独立危险因素。应用受试者工作特征曲线确定最佳截断值。
结果
研究了符合纳入标准的 851 例 KD 患者，其中 206 例为 CALs 组，645 例为非-CALs 组。CALs 组患儿 CRP 水平明显高于非-CALs 组（p<0.05）。多变量逻辑回归分析显示，不完全 KD、男性、较低的血红蛋白和较高的 CRP 是预测 CAL 的独立危险因素（均 p<0.05）。预测 CALs 的初始血清 CRP 的最佳截断值为 105.5mg/L，其敏感性为 47.57%，特异性为 69.61%。此外，CRP 较高（≥105.5mg/L）的 KD 患者发生 CALs 的几率高于 CRP 较低（<105.5mg/L）的患者（33%比 19%，p<0.001）。
结论
CRP 较高的患者 CALs 发生率明显更高。CRP 是 CALs 形成的独立危险因素，可能有助于预测 KD 患者的 CALs。
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