Xue Yan, Yin Jing, Xu Li, Dang Li-Heng, Wang Chao, Cui Ya-Qiong, Zhang Xin-Jie, Li Chong-Wei
Department of Rheumatology & Immunology, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin 300134, China (Li C-W, Email: leechongwei@126. com).
Zhongguo Dang Dai Er Ke Za Zhi. 2023 Dec 15;25(12):1211-1218. doi: 10.7499/j.issn.1008-8830.2305067.
Based on peripheral blood lymphocyte subsets and common laboratory test indexes, this study aimed to construct a predictive scoring system for intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD).
Children hospitalized in Tianjin Children's Hospital from January 2021 to March 2023 were included in the study (185 cases of IVIG-sensitive KD and 41 cases of IVIG -resistant KD). Forty-six healthy children matched for age and gender were selected as controls. The relative percentage and absolute counts of peripheral lymphocyte subsets were measured by flow cytometry. Multivariate logistic regression was used to identify the predictive factors for IVIG-resistant KD and to construct a predictive scoring system for predicting IVIG-resistant KD.
The multivariate logistic regression analysis showed that CD4 T cell absolute count, natural killer cell absolute count, serum sodium level, globulin level, and total bilirubin level were identified as predictive factors for IVIG-resistant KD (<0.05). The predictive scoring system based on these factors achieved a sensitivity of 70.7% and a specificity of 83.8% in predicting IVIG-resistant KD.
Peripheral blood lymphocyte subsets can serve as predictive indicators for IVIG-resistant KD in children. The introduction of this indicator and the establishment of a scoring system based on it can provide a higher accuracy in predicting IVIG-resistant KD in children.
基于外周血淋巴细胞亚群和常见实验室检查指标，本研究旨在构建静脉注射免疫球蛋白（IVIG）无反应性川崎病（KD）的预测评分系统。
纳入2021年1月至2023年3月在天津市儿童医院住院的儿童（185例IVIG敏感型KD和41例IVIG无反应性KD）。选取46例年龄和性别匹配的健康儿童作为对照。采用流式细胞术检测外周血淋巴细胞亚群的相对百分比和绝对计数。使用多因素logistic回归分析确定IVIG无反应性KD的预测因素，并构建预测IVIG无反应性KD的预测评分系统。
多因素logistic回归分析显示，CD4 T细胞绝对计数、自然杀伤细胞绝对计数、血清钠水平、球蛋白水平和总胆红素水平被确定为IVIG无反应性KD的预测因素（P<0.05）。基于这些因素的预测评分系统在预测IVIG无反应性KD时的灵敏度为70.7%，特异度为83.8%。
外周血淋巴细胞亚群可作为儿童IVIG无反应性KD的预测指标。引入该指标并建立基于此的评分系统可在预测儿童IVIG无反应性KD时提供更高的准确性。
