血沉对川崎病冠状动脉病变的预测价值研究

Predictive value of erythrocyte sedimentation rate for coronary artery lesions in Kawasaki disease

目的探讨血沉(ESR)对川崎病(KD)冠状动脉病变(CAL)的预测价值。方法收集2017年5月—2021年6月收治入院的KD患儿的临床资料,分析ESR对KD患儿CAL发生的预测作用。结果纳入272例KD患儿,70例KD患儿合并CAL,202例KD患儿无CAL。KD患儿的ESR升高。单因素分析提示CAL组的ESR低于非CAL组,差异有统计学意义(P<0.05)。ROC曲线下的面积为0.586,提示ESR可作为CAL的预测因子(P<0.05)。ESR预测川崎病冠脉病变发生的临界值为76.5 mm/h。二分类Logistic回归分析显示,ESR是KD患儿发生CAL的独立危险因素(P<0.05),当ESR<76.5 mm·h^(-1)时,KD患儿CAL发生风险增加(OR=2.38,95%CI:1.25~4.53)。结论KD急性期的ESR水平可用于预测KD患儿CAL的发生,ESR<76.5 mm·h^(-1)时,提示KD患儿可能会出现CAL。

Objective To investigate the predictive value of erythrocyte sedimentation rate(ESR)on coronary artery lesions(CAL)in Kawasaki disease(KD).Methods Clinical data of children with KD admitted to the hospital from May 2017 to June 2021 were collected to analyze the predictive value of ESR on the occurrence of CAL in children with KD.Results Of the 272 enrolled children with KD,70 children with CAL and 202 children without CAL.ESR was significantly higher in children with KD.Univariate analysis suggested that ESR was lower in the CAL group than in the non-CAL group,and the difference was statistically significant(P<0.05).The area under the ROC curve was 0.586,suggesting that ESR could be a predictor of CAL(P<0.05).The critical value of ESR for predicting the occurrence of CAL in KD was 76.5 mm/h.Dichotomous Logistic regression analysis showed that ESR was an independent risk factor for the development of CAL in children with KD(P<0.05),and the risk of CAL in children with KD was significantly increased when ESR was<76.5 mm/h.(OR=2.38,95%CI:1.25-4.53).Conclusions ESR levels in the acute phase of KD can be used to predict the development of CAL in children with KD,and ESR<76.5 mm/h suggests that children with KD may develop CAL.