[1]张绍洁,阎国辉,甘书芬.冠状动脉Z值等四联指标模型对黏膜皮肤淋巴结综合征的辅助诊断价值[J].福建医药杂志,2024,46(04):13-17.[doi:10.20148/j.fmj.2024.04.004]
　ZHANG Shaojie,YAN Guohui,GAN Shufen.Auxiliary diagnostic value of coronary artery Z-value and other quadruple index model for mucocutaneous lymph node syndrome[J].FUJIAN MEDICAL JOURNAL,2024,46(04):13-17.[doi:10.20148/j.fmj.2024.04.004]
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冠状动脉Z值等四联指标模型对黏膜皮肤淋巴结综合征的辅助诊断价值()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
46
期数:
2024年04期
页码:
13-17
栏目:
临床研究
出版日期:
2024-08-15

文章信息/Info

Title:
Auxiliary diagnostic value of coronary artery Z-value and other quadruple index model for mucocutaneous lymph node syndrome
文章编号:
1002-2600(2024)04-0013-05
作者:
张绍洁; 阎国辉; 甘书芬
厦门大学附属中山医院超声科,厦门 361004
Author(s):
ZHANG Shaojie; YAN Guohui; GAN Shufen
Department of Ultrasound,Zhongshan Hospital Xiamen University,Xiamen,Fujian 361004,China
关键词:
黏膜皮肤淋巴结综合征;  冠状动脉;  Z值;  发热时间;  白细胞介素-6;  C反应蛋白
Keywords:
mucocutaneous lymph node syndrome;  coronary artery;  Z value;  febrile duration;  interleukin-6;  C-reactive protein
分类号:
R445.1; R725.4
DOI:
10.20148/j.fmj.2024.04.004
文献标志码:
B
摘要:
目的 探讨冠状动脉Z值联合发热时间、白细胞介素-6(IL-6)、C反应蛋白(CRP)四联指标模型对黏膜皮肤淋巴结综合征(又称“川崎病”)的辅助诊断价值。方法 选取2017年1月至2022年12月厦门大学附属中山医院儿科收治的怀疑为川崎病的患儿165例,以临床诊断标准作为金标准最终确诊的83例为病例组(包括不完全川崎病),排除川崎病诊断的82例为对照组。收集患儿的临床资料和冠脉Z值,采用多因素logistic回归分析发病的独立危险因素,构建川崎病四联指标模型。绘制受试者工作特征曲线(ROC曲线),计算曲线下面积(AUC),用约登指数确定最佳诊断阈值。用Kappa值评价四联指标模型与临床诊断标准的一致性。结果 冠脉Z值、发热时间、IL-6、CRP是川崎病的独立危险因素,最佳诊断阈值分别为:冠脉Z值1.5,发热时间5.5 d,IL-6 31 pg/mL,CRP 42 mg/L。基于独立危险因素构建的四联指标模型AUC为0.960,Kappa值为0.867,诊断价值高于各独立危险因素,与临床诊断标准具有较好的一致性。结论 冠脉Z值联合发热时间、IL-6、CRP构建的四联指标模型能有效地辅助临床诊断并减少漏诊,为提高KD诊断效率提供参考依据。
Abstract:
Objective To explore the auxiliary diagnostic value of coronary artery Z-value combined with febrile duration,IL-6,CRP for mucocutaneous lymph node syndrome(also known as Kawasaki disease). Methods A total of 165 suspected cases of Kawasaki disease admitted in paediatric ward of Zhongshan Hospital Xiamen University from January 2017 to December 2022 were enrolled in this study.Among the 165 cases,83 were confirmed having Kawasaki disease(including incomplete Kawasaki disease),and the other 82 cases were excluded. Clinical data and coronary artery Z-value of the children were collected. Multivariate logistic regression was used to analyze the independent risk factors. A quadruple index model for the disease was constructed. Receiver operating characteristic curve(ROC)analysis was used to calculate the area under the curve(AUC),and the optimal diagnostic threshold was determined by Youden index. Kappa value was used to evaluate the consistency between quadruple index diagnostic model and clinical diagnostic criteria. Results Coronary artery Z-value,febrile duration,IL-6,CRP were the independent risk factors of Kawasaki disease. The optimal diagnostic threshold was 1.5 for coronary artery Z-value,5.5 d for febrile duration,31 pg/mL for IL-6 and 42 mg/L for CRP. The AUC of quadruple index diagnostic model was 0.960,Kappa value was 0.867. Its diagnostic value was higher than those of independent risk factors,and it has high consistency with clinical diagnostic criteria. Conclusion Coronary artery Z-value combined with febrile duration,IL-6 and CRP quadruple index model can effectively assist clinical diagnosis and reduce missed diagnosis,and provide reference for improving the efficiency of Kawasaki disease diagnosis.

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更新日期/Last Update: 2024-08-15