■为了评价D-二聚体的性能,凝血酶原时间(PT),和红细胞分布宽度(RDW)用于诊断川崎病(KD)急性期的冠状动脉病变(CAL)。
在2018年1月至2021年1月之间,共有102名急性期KD儿童被纳入这项回顾性研究。其中,将36名患有CAL的KD儿童分为CAL组,66名没有CAL的KD儿童被分为NCAL组。使用单变量和多变量逻辑回归分析确定急性期KDCAL的独立预测因子。使用Spearman相关性评估急性期KDCAL与不同指标之间的相关性。通过受试者工作特征(ROC)曲线分析不同指标对急性KD期CAL的诊断性能。
■与NCAL组相比,CAL组儿童的白细胞计数明显较高,淋巴细胞计数,血小板计数,D-二聚体,和RDW水平,但PT水平较低(所有p<0.05)。Logistic回归分析显示D-二聚体(OR=1.0,95%CI:1.004-1.012,p<0.001),PT(OR=0.4,95%CI:0.2-0.8,p=0.01),RDW(OR=7.0,95%CI:2.6-19.2,p<0.001)是急性期KD患儿CAL的独立预测因子。CAL与D-二聚体(r=0.4,p<0.001)和RDW(r=0.5,p<0.001)呈正相关,与PT呈负相关(r=-0.2,p<0.05)。ROC曲线分析显示,3项指标组合对急性KD期CAL的诊断效能最高,曲线下面积(AUC)为0.922(敏感性,86.1%;特异性,89.4%),与D-二聚体相比(AUC=0.736),PT(AUC=0.640),和单独的RDW(AUC=0.819)。
■D-二聚体的组合,PT,RDW可能有助于预测KD急性期儿童的CAL。
UNASSIGNED: To evaluate the performances of D-dimer, prothrombin time (PT), and
red blood cell distribution width (RDW) for the diagnosis of coronary artery lesion (CAL) in acute stage Kawasaki disease (KD).
UNASSIGNED: Between January 2018 and January 2021, a total of 102 children with acute stage KD were included in this retrospective study. Among them, 36 KD children with CAL were divided into the CAL group, and 66 KD children without CAL were divided into the NCAL group. Independent predictors of CAL in acute stage KD were identified by using univariate and multivariate logistic regression analysis. Spearman correlations were used to evaluate the association between CAL in acute stage KD and different indicators. The diagnostic performance of different indicators for CAL in acute stage KD was analyzed by the receiver operating characteristic (ROC) curve.
UNASSIGNED: Compared with the NCAL group, children in the CAL group had significantly higher white blood cell count, lymphocyte count, platelet count, D-dimer, and RDW levels, but lower PT levels (all p < 0.05). Logistic regression analysis revealed that D-dimer (OR = 1.0, 95% CI: 1.004-1.012, p < 0.001), PT (OR = 0.4, 95% CI: 0.2-0.8, p = 0.01), and RDW (OR = 7.0, 95% CI: 2.6-19.2, p < 0.001) were independent predictors of CAL in children with acute stage KD. CAL showed a positive correlation with D-dimer (r = 0.4, p < 0.001) and RDW (r = 0.5, p < 0.001), and had a negative association with PT (r = -0.2, p < 0.05). The ROC curve analysis showed that the combination of the three indicators had the highest diagnostic performance for CAL in acute stage KD with an area under the curve (AUC) of 0.922 (sensitivity, 86.1%; specificity, 89.4%), compared with D-dimer (AUC = 0.736), PT (AUC = 0.640), and RDW (AUC = 0.819) alone.
UNASSIGNED: A combination of D-dimer, PT, and RDW may help predict CAL in children with acute stage KD.