多重炎症指数对川崎病患儿心血管并发症的预测价值

Predictive Value of Multiple Inflammatory Indices for Cardiovascular Complications in Children with Kawasaki Disease

目的:探讨多重炎症指数对川崎病患儿心血管并发症的预测价值。方法:连续性收集本院2020年1月至2022年5月收治为KD患儿127例为研究对象,根据MII中位数将其分为高MII组和低MII组。采用自制一般资料调查表收集患儿性别、年龄等人口学资料,通过电子病历系统获取患儿发热时间、结膜充血、淋巴结肿大等临床资料。对患儿进行为期12个月的心血管并发症为结局的随访。结果:高MII组和低MII组性别、发热时间、淋巴结肿大率比较差异无统计学意义(P>0.05),高MII组年龄、结膜充血率高于低MII组,差异具有统计学意义(P<0.05)。K-M生存曲线分析结果显示,高MII-1组、高MII-2组中位心血管并发症发生率分别为87.50%和90.63%,低MII-1组、低MII-2组中位心血管并发症发生率分别为76.19%和74.60%,两组比较差异具有统计学意义(χ^(2)=10.680、10.860,P=0.001、0.001)。多因素分析显示,MII-1(OR=2.247,P<0.001)、MII-2(OR=2.134,P<0.001)是KD患儿发生心血管并发症的独立影响因素。ROC分析结果显示,当MII-1、MII-2分别取值784.64、21876.76时,对KD患儿随访12个月后发生心血管并发症达到最大预测效能,此时曲线下面积分别为0.680、0.726。结论:多重炎症指数对于预测川崎病患儿心血管并发症有一定临床价值,值得临床推广应用。

Objective:To explore the predictive value of multiple inflammatory indices for cardiovascular complications in children with Kawasaki disease.Methods:A total of 127 children with KD admitted to our hospital from January 2020 to May 2022 were continuously collected as the research subjects,and they were divided into high MII group and low MII group according to the median of MII.Demographic data such as gender and age were collected using self-made general information questionnaire,and clinical data such as fever time,conjunctival hyperemia,and lymphadenopathy were obtained through electronic medical record system.Children were followed up for 12 months with cardiovascular complications as the outcome.Results:There was no significant difference in gender,fever time,and lymph node enlargement rate between the high MII group and the low MII group(P>0.05).The age and conjunctival hyperemia rate in the high MII group were higher than those in the low MII group,and the differences were statistically significant(P<0.05).The results of the K-M survival curve analysis showed that the median cardiovascular complication rates were 87.50%and 90.63%in the high MII-1 and high MII-2 groups,respectively,and 76.19%and 74.60%in the low MII-1 and low MII-2 groups,respectively,with statistically significant differences between the two groups(χ^(2)=10.680,10.860,P=0.001,0.001).Multivariate analysis showed that MII-1(OR=2.247,P<0.001)and MII-2(OR=2.134,P<0.001)were independent influencing factors of cardiovascular complications in children with KD.The results of ROC analysis showed that when the values of MII-1 and MII-2 were 784.64 and 21876.76,respectively,the maximum predictive performance of cardiovascular complications in children with KD after 12 months of follow-up was achieved,and the areas under the curve were 0.680 and 0.726,respectively.CONLCLUSIONS Multiple inflammatory indices have certain clinical value in predicting cardiovascular complications in children with Kawasaki disease,and are worthy of clinical application。