BNP联合原田危险评分在不完全川崎病早期诊断中的意义

Significance of BNP Combined with Harada Risk Score in Early Diagnosis of Incomplete Kawasaki Disease

目的:探析脑钠肽(BNP)联合原田危险评分在不完全川崎病(IKD)早期诊断中的意义。方法:回顾性选取2018年1月-2021年1月在东莞市松山湖中心医院接受诊治的64例IKD患儿为观察组,另选取同期于医院接受诊治的60例非IKD发热患儿为对照组。对比分析两组临床诊断资料,评价BNP、原田危险评分、BNP联合原田危险评分对IKD早期诊断的预测效能。结果:两组年龄、性别对比,差异无统计学意义(P>0.05);观察组的BNP、红细胞沉降率(ESR)、白细胞(WBC)、血小板(PLT)、D-二聚体(D-D)、降钙素原(PCT)、C反应蛋白(CRP)、谷丙转氨酶(ALT)水平及原田危险评分高于对照组,血浆白蛋白(Alb)低于对照组,差异均有统计学意义(P<0.05)。BNP联合原田危险评分早期诊断IKD的灵敏度和准确度均明显高于BNP、原田危险评分单独诊断,差异均有统计学意义(P<0.05);BNP联合原田危险评分早期诊断IKD的特异度与BNP、原田危险评分单独诊断对比,差异无统计学意义(P>0.05)。结论:BNP与原田危险评分联合诊断早期IKD的灵敏度和准确度更高,可作为IKD早期确诊的参考指标之一。

Objective:To explore the significance of brain natriuretic peptide(BNP)combined with Harada risk score in the early diagnosis of incomplete Kawasaki disease(IKD).Method:A total of 64 patients with IKD in Dongguan Songshanhu Central Hospital from January 2018 to January 2021 were retrospectively selected as the observation group,and 60 children with non IKD fever who were treated in the hospital during the same period were selected as the control group.The clinical diagnosis data of the two groups were compared and analyzed,the predictive value of BNP,Harada risk score and BNP combined with Harada risk score in early diagnosis of IKD was evaluated.Result:There was no significant difference in age and gender between the two groups(P>0.05).The levels of BNP,erythrocyte sedimentation rate(ESR),white blood cells(WBC),platelets(PLT),D-dimer(D-D),procalcitonin(PCT),C-reactive protein(CRP),alanine aminotransferase(ALT)and Harada risk score in the observation group were higher than those in the control group,and the plasma albumin(Alb)was lower than that in the control group,the differences were statistically significant(P<0.05).The sensitivity and accuracy of BNP combined with Harada risk score in early diagnosis of IKD were significantly higher than those of BNP and Harada risk score alone,the differences were statistically significant(P<0.05).There was no significant difference in the specificity of early diagnosis of IKD between BNP combined with Harada risk score and BNP or Harada risk score alone(P>0.05).Conclusion:BNP combined with Harada risk score has higher sensitivity and accuracy in the diagnosis of early IKD,which can be used as one of the reference indexes for early diagnosis of IKD.