苏州地区IVIG无反应型川崎病危险因素分析及其预测评分体系的建立

Analysis of risk factors of intravenous immunoglobulin in children with non-responsive Kawasaki disease in Suzhou area and establishment of its predictive scoring system

目的分析苏州地区静脉注射用免疫球蛋白(IVIG)无反应型川崎病(KD)危险因素并建立其预测评分体系。方法回顾性分析苏州地区723例KD患儿临床资料。多因素回归分析KD患儿IVIG无反应型的危险因素。通过对危险因素赋值,建立苏州地区IVIG无反应型KD的预测评分体系。结果年龄<6个月、手足硬肿、中性粒细胞百分比≥80%及血清白蛋白<35g/L是IVIG无反应型KD独立危险因素(P<0.05)。年龄<6个月和血清白蛋白<35g/L均赋予2分,手足硬肿和中性粒细胞百分比≥80%均赋予1分。以总分3分为截点值,其预测IVIG无反应型KD灵敏度为72.1%,特异度为75.3%。结论建立了苏州地区IVIG无反应型KD的预测评分体系。临床多关注IVIG无反应型危险因素可提高对KD患儿IVIG抵抗的预测准确度。

Objective To analyze the risk factors of intravenous immunoglobulin（IVIG）in children with non-responsive Kawasaki disease（KD）in Suzhou area and establish its predictive scoring system.Methods The data of 723 children with non-responsive KD in Suzhou area were retrospectively analyzed.The risk factors of IVIG non-responsive KD were analyzed,based on which the predictive scoring system of IVIG non-responsive KD was established.Results The age less than6 months,extremity edema,neutrophils percentage≥80% and serum albumin35 g/L were the independent risk factors for IVIG non-responsive KD（P〈0.05）.The age less than 6 months was scored as 2 points,serum albumin35 g/L as 2 points,extremity edema as one point,and neutrophils percentage≥80% as one point.Taking 3 points as the cut-off value,the sensitivity and specificity in predicting IVIG non-reactive KD were 72.1%and 75.3%,respectively.Conclusion Predictive scoring system of IVIG non-responsive KD in Suzhou area is established.An attention should be paid to the children with multiple IVIG non-responsive risk factors to improve the predictive accuracy of IVIG resistance in children with KD.