Wang Rui, Wei Dan, Gu Min, Mi Jiao, Hu Xing, Pu Wanli
Department of Pediatrics, Pidu Maternal and Child Care Hospital.
Department of Pediatrics, Chongzhou Maternal and Child Health Care Hospital.
Coron Artery Dis. 2025 Sep 1;36(6):510-514. doi: 10.1097/MCA.0000000000001492. Epub 2025 Jul 30.
Kawasaki disease (KD) is a common children's disease with unknown etiology, which easily involves coronary artery and causes serious cardiovascular sequelae. The purpose was to investigate the relationship between chitotriosidase activity and coronary artery aneurysm (CAA) and develop and validate a nomogram to predict CAA in KD patients.
A total of 338 KD patients were included in this study. Differences analysis compared baseline characteristics and multivariate logistic regression analysis to determine independent risk factors for CAA in KD patients. Based on this independent risk factor, the nomogram was constructed and validated.
Of 338 KD patients, 107 patients developed CAA. Multivariate logistic regression analysis identified that low-density lipoprotein (LDL) [odds ratio (OR):1.456, 95% confidence interval (CI): 1.062-1.996], age (OR: 0.986, 95% CI: 0.974-0.998), neutrophil-to-lymphocyte ratio (NLR) (OR: 1.098, 95% CI: 1.020-1.182), and chitotriosidase activity (OR: 1.115, 95% CI: 1.111-1.192) were independent predictors for CAA. The nomogram was established based on serum chitotriosidase activity and clinical characteristics, and this nomogram has demonstrated to be of potential value in clinical practice using the receiver operating characteristic curve, calibration curve, and decision curve analysis.
LDL, age, NLR, and chitotriosidase activity were independent risk factors for CAA. Based on this independent risk factor, the nomogram was constructed to guide clinicians to effectively predict CAA and adopt appropriate interventions such as more aggressive anti-inflammatory and more frequent follow-up.
川崎病（KD）是一种病因不明的常见儿童疾病，易累及冠状动脉并导致严重的心血管后遗症。本研究旨在探讨壳三糖苷酶活性与冠状动脉瘤（CAA）之间的关系，并开发和验证一种用于预测KD患者发生CAA的列线图。
本研究共纳入338例KD患者。采用差异分析比较基线特征，并进行多因素逻辑回归分析以确定KD患者发生CAA的独立危险因素。基于这些独立危险因素构建并验证列线图。
338例KD患者中，107例发生了CAA。多因素逻辑回归分析确定，低密度脂蛋白（LDL）[比值比（OR）：1.456，95%置信区间（CI）：1.062 - 1.996]、年龄（OR：0.986，95%CI：0.974 - 0.998）、中性粒细胞与淋巴细胞比值（NLR）（OR：1.098，95%CI：1.020 - 1.182）和壳三糖苷酶活性（OR：1.115，95%CI：1.111 - 1.192）是CAA的独立预测因素。基于血清壳三糖苷酶活性和临床特征建立了列线图，通过受试者工作特征曲线、校准曲线和决策曲线分析表明该列线图在临床实践中具有潜在价值。
LDL、年龄、NLR和壳三糖苷酶活性是CAA的独立危险因素。基于这些独立危险因素构建了列线图，以指导临床医生有效预测CAA并采取适当的干预措施，如更积极的抗炎治疗和更频繁的随访
