Background We aimed to explore predictive measures for intravenous immunoglobulin(IVIG)resistance in children with Kawasaki disease(KD).Methods Patients diagnosed with KD were enrolled in this study.Univariate analysi...Background We aimed to explore predictive measures for intravenous immunoglobulin(IVIG)resistance in children with Kawasaki disease(KD).Methods Patients diagnosed with KD were enrolled in this study.Univariate analysis and multiple logistic regression were utilized to analyze the clinical features and laboratory results prior to IVIG-treatment of the two groups.Independent predictors of IVIG resistance were analyzed,and a predictive model for KD children with IVIG resistance was constructed.Results A total of 277 children with KD,180 boys and 97 girls,aged 2-128(median 23)months,were enrolled in the study.Compared with the IVIG-responsive group,the IVIG-resistant group had higher levels of the peripheral neutrophil count,mean platelet volume,mean platelet volume-to-lymphocyte ratio and C-reactive protein,and total serum bilirubin,but lower levels of peripheral lymphocyte count,serum albumin and serum prealbumin.Age(in months),peripheral neutrophil count,lymphocyte count and mean platelet volume and serum albumin were independent indicators for IVIG resistance by multivariate logistic regression analysis.A logistic regression model and a scoring system were set up,where cut-off values of—0.46 and 6.5 points yielded sensitivities of 83.9%and 77.4%,and specificities of 74.8%and 61.0%,respectively.The areas under the curve(AUC)were 0.808 in the logistic regression model,and 0.750 in the scoring system.Conclusion Our model for predicting IVIG-resistant children with KD,involving age(months),peripheral neutrophil count,lymphocyte count and mean platelet volume and serum albumin prior to IVIG-treatment,is helpful for clinical prediction of children with IVIG-resistant KD.展开更多
Background： The pathogenesis of postural tachycardia syndrome （POTS） remains unclear. This study aimed to explore the changes and significance of sulfur dioxide （SO2） in patients with POTS. Methods： The study in...Background： The pathogenesis of postural tachycardia syndrome （POTS） remains unclear. This study aimed to explore the changes and significance of sulfur dioxide （SO2） in patients with POTS. Methods： The study included 31 children with POTS and 27 healthy children from Peking University First Hospital between December 2013 and October 2015. A detailed medical history, physical examination results, and demographic characteristics were collected. Hemodynamics was recorded and the plasma SO2was determined. Results： The plasma SO2was significantly higher in POTS children compared to healthy children （64.0 ± 20.8 μmol/L vs. 27.2 ± 9.6 μmol/L, respectively, P 〈 0.05）. The symptom scores in POTS were positively correlated with plasma SO2levels （r = 0.398, P 〈 0.05）. In all the study participants, the maximum heart rate （HR） was positively correlated with plasma levels of SO2（r = 0.679, P 〈 0.01）. The change in systolic blood pressure from the supine to upright （ΔSBP） in POTS group was smaller than that in the control group （P 〈 0.05）. The ΔSBP was negatively correlated with baseline plasma SO2levels in all participants （r = ？0.28, P 〈 0.05）. In the control group, ΔSBP was positively correlated with the plasma levels of SO2（r = 0.487, P 〈 0.01）. The change in HR from the supine to upright in POTS was obvious compared to that of the control group. The area under curve was 0.967 （95% confidence interval： 0.928–1.000）, and the cutoff value of plasma SO2level 〉38.17 μmol/L yielded a sensitivity of 90.3% and a specificity of 92.6% for predicting the diagnosis of POTS. Conclusions： Increased endogenous SO2levels might be involved in the pathogenesis of POTS.展开更多
基金financially supported by the National Key R&D Program of China(No.2021YFB2012100)the National Natural Science Foundation of China(Nos.U19A2087,52172134)+1 种基金the Construction of Innovative Provinces in Hunan Province,China(No.2020GK2062)the State Key Laboratory of Powder Metallurgy,Central South University,China。
基金The work was supported by Peking University Clinical Scientist Program(BMU2019LCKXJ001)and Fundamental Research for the Central Universities.
文摘Background We aimed to explore predictive measures for intravenous immunoglobulin(IVIG)resistance in children with Kawasaki disease(KD).Methods Patients diagnosed with KD were enrolled in this study.Univariate analysis and multiple logistic regression were utilized to analyze the clinical features and laboratory results prior to IVIG-treatment of the two groups.Independent predictors of IVIG resistance were analyzed,and a predictive model for KD children with IVIG resistance was constructed.Results A total of 277 children with KD,180 boys and 97 girls,aged 2-128(median 23)months,were enrolled in the study.Compared with the IVIG-responsive group,the IVIG-resistant group had higher levels of the peripheral neutrophil count,mean platelet volume,mean platelet volume-to-lymphocyte ratio and C-reactive protein,and total serum bilirubin,but lower levels of peripheral lymphocyte count,serum albumin and serum prealbumin.Age(in months),peripheral neutrophil count,lymphocyte count and mean platelet volume and serum albumin were independent indicators for IVIG resistance by multivariate logistic regression analysis.A logistic regression model and a scoring system were set up,where cut-off values of—0.46 and 6.5 points yielded sensitivities of 83.9%and 77.4%,and specificities of 74.8%and 61.0%,respectively.The areas under the curve(AUC)were 0.808 in the logistic regression model,and 0.750 in the scoring system.Conclusion Our model for predicting IVIG-resistant children with KD,involving age(months),peripheral neutrophil count,lymphocyte count and mean platelet volume and serum albumin prior to IVIG-treatment,is helpful for clinical prediction of children with IVIG-resistant KD.
文摘Background： The pathogenesis of postural tachycardia syndrome （POTS） remains unclear. This study aimed to explore the changes and significance of sulfur dioxide （SO2） in patients with POTS. Methods： The study included 31 children with POTS and 27 healthy children from Peking University First Hospital between December 2013 and October 2015. A detailed medical history, physical examination results, and demographic characteristics were collected. Hemodynamics was recorded and the plasma SO2was determined. Results： The plasma SO2was significantly higher in POTS children compared to healthy children （64.0 ± 20.8 μmol/L vs. 27.2 ± 9.6 μmol/L, respectively, P 〈 0.05）. The symptom scores in POTS were positively correlated with plasma SO2levels （r = 0.398, P 〈 0.05）. In all the study participants, the maximum heart rate （HR） was positively correlated with plasma levels of SO2（r = 0.679, P 〈 0.01）. The change in systolic blood pressure from the supine to upright （ΔSBP） in POTS group was smaller than that in the control group （P 〈 0.05）. The ΔSBP was negatively correlated with baseline plasma SO2levels in all participants （r = ？0.28, P 〈 0.05）. In the control group, ΔSBP was positively correlated with the plasma levels of SO2（r = 0.487, P 〈 0.01）. The change in HR from the supine to upright in POTS was obvious compared to that of the control group. The area under curve was 0.967 （95% confidence interval： 0.928–1.000）, and the cutoff value of plasma SO2level 〉38.17 μmol/L yielded a sensitivity of 90.3% and a specificity of 92.6% for predicting the diagnosis of POTS. Conclusions： Increased endogenous SO2levels might be involved in the pathogenesis of POTS.
