临床儿科杂志 ›› 2018, Vol. 36 ›› Issue (1): 1-.doi: 10.3969/j.issn.1000-3606.2018.01.001

• 免疫性疾病专栏 •    下一篇

丙种球蛋白非敏感型川崎病危险因素分析

吴自明1, 张正宇1, 罗昭旸2, 石秦林2, 赵文龙1   

  1. 1.重庆医科大学医学信息学院卫生决策与医疗大数据教研室(重庆 400016);2.重庆医科大学附属 儿童医院心内科(重庆 400014)
  • 收稿日期:2018-01-15 出版日期:2018-01-15 发布日期:2018-01-15
  • 通讯作者: 赵文龙  E-mail:cqzhaowl@163.com
  • 基金资助:
    重庆市自然科学基金项目(No.cstc2015shmszx10004)

Analysis of the risk factors of intravenous immunoglobin-resistant Kawasaki diseases

WU Ziming1, ZHANG Zhengyu1, LUO Zhaoyang2, SHI Qinlin2, ZHAO Wenlong1   

  1. 1. Department of Health Decision Making, School of Medical Informatics, Chongqing Medical University, Chongqing 400016, China; 2. Children's Hospital of Chongqing Medical University, Chongqing 400014, China
  • Received:2018-01-15 Online:2018-01-15 Published:2018-01-15

摘要:  目的 探讨丙种球蛋白非敏感型川崎病早期实验室检查中的危险指标。方法 回顾性分析2015年7月1日至 2016年6月30日881例川崎病患儿的临床资料,其中丙种球蛋白非敏感型患儿26例(A组),一般型855例(B组)。通过以年龄、 性别1:3为匹配条件的logistic回归分析,构建各变量[性别、月龄、发热天数、体温、红细胞计数(RBC)、白细胞计数(WBC)、 中性粒细胞(N)、淋巴细胞(L)、血小板计数(PLT)、C反应蛋白(CRP) ]的回归模型。结果   与B组相比, A组的RBC计数 较低,PLT较高,差异均有统计学意义(P<0.05)。以月龄为条件logistic回归分析回归模型为Y=-2.87+0.01×PLT(PLT: OR=1.01,95%CI:1.00~1.01, P<0.01),以性别为条件logistic回归分析回归模型为Y=-32.98+0.44×WBC+0.28×N +0.01×PLT(WBC:OR=1.55,95%CI:1.17~2.05, P<0.01;N%:OR=1.32,95%CI:1.04~1.68, P<0.05;PLT: OR=1.01,95%CI:1.00~1.01, P<0.01)。 结论 确诊川崎病时伴随PLT水平异常增高,需要警惕丙种球蛋白无反应型的 可能。

Abstract: Objective To explore the early laboratory indicators for risk of intravenous immunoglobin-resistant Kawasaki diseases. Methods The clinical data were retrospectively analyzed in 881 Kawasaki disease patients (group A: 26 cases of intravenous immunoglobin-resistant; group B: 855 cases of intravenous immunoglobin-sensitive) from July 1, 2015 to June 30, 2016. After 1:3 matching with age and sex, the regression model for each of variables including sex, age, fever days, temperature, red blood cell count (RBC), white blood cell count (WBC), neutrophil (N), lymphocyte (L), platelet count (PLT) and C reactive protein (CRP), was constructed by conditional logistic regression analysis. Results Compared with group B, group A had significantly lower RBC count and higher PLT (P<0.05). Logistic regression analysis showed that, with the age, the regression model was Y=-2.87+0.01×PLT (PLT OR=1.01, 95%CI: 1.00~1.01, P<0.01); with the sex, Y=-32.98+0.44×WBC+0.28×          N+0.01×PLT (WBC OR=1.55, 95%CI: 1.17~2.05, P<0.01; N% OR=1.32, 95%CI: 1.04~1.68, P<0.05; PLT OR=1.01, 95%CI 1.00~1.01, P<0.01). Conclusion In case that abnormally high levels of PLT exist in confirmed Kawasaki disease, it should be aware of possibility of the intravenous immunoglobin-resistant Kawasaki disease.