摘要
目的探讨白细胞介素-6(IL-6)联合红细胞分布宽度(RDW)对川崎病患儿并发冠状动脉病变的预测价值。方法回顾性收集2022年1月至2024年10月安徽省儿童医院收治的133例川崎病患儿进行研究。按是否并发CAL,将患儿分为CAL组(n=39)与非CAL组(n=94)。对两组一般资料和血清IL-6、RDW等实验室指标进行对比分析,采用多因素Logistic回归分析影响川崎病并发CAL的危险因素;采用受试者操作特征(ROC)曲线评定各指标对川崎病并发CAL的预测价值。结果CAL组男性占比、IVIG不敏感川崎病占比、心功能不全占比和低蛋白血症占比分别为74.36%、33.33%、25.64%、28.21%,均显著高于非CAL组(53.19%、12.77%、5.32%、12.77%),差异均有统计学意义(P<0.05);两组年龄构成及其他临床特征比较,差异均无统计学意义(P>0.05)。CAL组血清CRP、RDW和IL-6水平分别为(107.54±15.47)g/L、(14.28±3.15)%、(113.45±30.48)pg/mL,均显著高于非CAL组[(114.48±17.31)g/L、(11.87±2.34)%、(79.36±21.68)pg/mL],血红蛋白水平为(107.54±15.47)g/L,显著低于非CAL组[(114.48±17.31)g/L],差异均有统计学意义(P<0.05);两组其他实验室指标比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析,得出男性(OR=1.196)、发热时间(OR=2.396)及血清IL-6(OR=1.332)、RDW(OR=1.473)为川崎病并发CAL的危险因素(P<0.05)。ROC曲线分析得出,血清IL-6、RDW水平均对川崎病并发CAL有一定预测价值,其AUC分别为0.829、0.737,二者联合预测的AUC为0.888,相比单项指标显著提升(P<0.05)。结论血清IL-6、RDW水平均与川崎病患儿并发CAL具有相关性,二者可作为预测指标,联合应用对川崎病并发CAL有较高预测价值。
Objective To investigate the predictive value of interleukin-6(IL-6)combined with red blood cell distribution width(RDW)for coronary artery lesions(CAL)in children with Kawasaki disease(KD).Methods A retrospective study was conducted on 133 children with Kawasaki disease admitted to Anhui Children's Hospital from January 2022 to October 2024.The patients were divided into the CAL group(n=39)and the non-CAL group(n=94)according to whether they were complicated with CAL.The general data and laboratory indexes such as serum IL-6 and RDW of the two groups were compared and analyzed,and the risk factors of KD complicated with CAL were analyzed by multivariate Logistic regression.The receiver operator characteristic(ROC)curve was used to evaluate the predictive value of each index for KD complicated with CAL.Results The proportion of male,IVIG insensitive Kawasaki disease,cardiac insufficiency and hypoproteinemia in the CAL group were 74.36%,33.33%,25.64%and 28.21%,respectively,which were significantly higher than those in the non-CAL group(53.19%,12.77%,5.32%,12.77%),the differences were statistically significant(P<0.05).There were no statistically significant differences in age composition and other clinical characteristics between the two groups(P>0.05).The levels of serum CRP,RDW and IL-6 in the CAL group were(107.54±15.47)g/L,(14.28±3.15)%and(113.45±30.48)pg/mL,respectively,which were significantly higher than those in the non-CAL group[(114.48±17.31)g/L,(11.87±2.34)%,(79.36±21.68)pg/mL],and the hemoglobin level was(107.54±15.47)g/L,which was significantly lower than that in the non-CAL group[(114.48±17.31)g/L],the differences were statistically significant(P<0.05).There were no statistically significant differences in other laboratory indexes between the two groups(P>0.05).Multivariate Logistic regression analysis showed that male(OR=1.196),fever time(OR=2.396),serum IL-6(OR=1.332)and RDW(OR=1.473)were the risk factors for KD complicated with CAL(P<0.05).ROC curve analysis showed that serum IL-6 and RDW levels had certain predictive value for KD complicated with CAL,and their AUCs were 0.829 and 0.737,respectively.The AUC of combined prediction was 0.888,which was significantly higher than that of single index(P<0.05).Conclusion Serum IL-6 and RDW levels are correlated with CAL in children with KD,and the two can be used as predictors.The combined application has a high predictive value for KD complicated with CAL.
作者
靳晶晶
卢松建
林宏华
JIN Jingjing;LU Songjian;LIN Honghua(Department of Clinical Immunology,Anhui Children's Hospital,Hefei Anhui 230000,China)
出处
《临床和实验医学杂志》
2025年第18期1958-1961,共4页
Journal of Clinical and Experimental Medicine
基金
安徽省卫生健康科研项目(编号:AHWJ2022b008)
关键词
川崎病
冠状动脉病变
白细胞介素-6
红细胞分布宽度
预测
Kawasaki disease
Coronary artery lesions
Interleukin-6
Red blood cell distribution width
Prediction
