›› 2018, Vol. 36 ›› Issue (10): 765-.doi: 10.3969/j.issn.1000-3606.2018.10.010

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Predictive analysis of intravenous immunoglobulin unresponsive Kawasaki disease

 XIAO Lan, ZHANG Jing, YI Lunyu, QIU Ling, YANG Ying, YE Xiaochun   

  1. Department of General Medicine, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
  • Received:2018-10-15 Online:2018-10-15 Published:2018-10-15

Abstract:  Objective To evaluate the value of different scoring systems in the prediction of intravenous immunoglobulin (IVIG) unresponsive Kawasaki disease in Chinese children, and to explore the risk factors of IVIG unresponsive Kawasaki disease, so as to establish a predictive scoring system for IVIG unresponsive Kawasaki disease in Chinese children. Method The clinical data of 1 655 children with Kawasaki disease in China were analyzed retrospectively. The Kobayashi score, Egami score, Sano score, Fu score, Formosa score and Tang score were used to predict IVIG unresponsiveness of patients and their predictive capability were evaluated. Univariate analysis, logistic regression analysis and receiver operating characteristic curve (ROC) were used to analyze the independent risk factors of Kawasaki disease unresponsive to initial IVIG treatment in Chinese children, and a new predictive scoring system was attempted to establish. Results The incidence of IVIG unresponsive Kawasaki disease is higher in patients with lower platelets and serum sodium, higher percentage of neutrophils and total bilirubin (P<0.05). The above four risk factors were used to establish a new predictive scoring system, and the score ≥2 points suggested IVIG unresponsive Kawasaki disease. The new predictive scoring system have a sensitivity of 70.4%, a specificity of 72.7%, and an area under the ROC curve of 0.767. Conclusion Platelets, percentage of neutrophils, total bilirubin, and serum sodium were associated with IVIG unresponsive Kawasaki disease. The new scoring system established in this study has high sensitivity and specificity, but its predictive efficacy in other regions and populations needs further confirmation.