Egami评分及D二聚体/纤维蛋白原对川崎病患儿并发冠状动脉病变的预测价值

Predictive Value of Egami Score and D-Dimer/Fibrinogen for Coronary Artery Lesions in Kawasaki Disease Children

摘要: 目的：探讨Egami评分及血清D二聚体/纤维蛋白原对川崎病(KD)并发冠状动脉病变(CAL)的预测价值。方法：选取114例KD患儿，其中并发CAL 35例、未并发CAL 79例。根据病程及入院后的实验室检测结果进行Egami评分，入院24 h内采集空腹静脉血，检测血清D二聚体、纤维蛋白原，计算D二聚体/纤维蛋白原。收集患儿临床资料，采用Logistic回归分析Egami评分及D二聚体/纤维蛋白原对KD并发GAL的影响；绘制受试者工作特征(ROC)曲线，分析Egami评分、D二聚体/纤维蛋白原对KD并发GAL的预测效能。结果：在共计114例研究对象中，CAL并发与非并发者分别为35例与79例。经Logistic回归分析显示，较高水平的白介素6 (IL-6)、D二聚体、Egami评分及较高水平的D二聚体/纤维蛋白原是KD并发CAL的独立危险因素(P均<0.05)。ROC曲线分析显示，Egami评分、D二聚体/纤维蛋白原预测KD患儿并发CAL的AUC分别为0.709、0.644，二者联合预测的AUC为0.799。结论：对于KD患儿，较高水平的Egami评分及血清D二聚体/纤维蛋白原均会增加其并发CAL的风险，二者可作为预测指标，联合应用对川崎病并发CAL有中等程度预测价值。

Abstract: Objective: To investigate the predictive value of the Egami score and serum D-dimer/fibrinogen ratio for coronary artery lesions (CAL) complicating Kawasaki disease (KD). Methods: A total of 114 children with KD were selected, including 35 with CAL and 79 without CAL. The Egami score was calculated based on the course of the disease and laboratory test results after admission. Fasting venous blood was collected within 24 hours of admission to measure serum D-dimer and fibrinogen levels, and the D-dimer/fibrinogen ratio was calculated. Clinical data of the children were collected. Logistic regression analysis was used to analyze the impact of the Egami score and the D-dimer/fibrinogen ratio on CAL complicating KD. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive efficacy of the Egami score and the D-dimer/fibrinogen ratio for CAL complicating KD. Results: Among the 114 children, 35 had CAL and 79 did not. The logistic regression model demonstrated a significant association with higher concentrations of interleukin-6 (IL-6), D-dimer, Egami score, and a higher D-dimer/fibrinogen ratio were independent risk factors for CAL complicating KD (all P < 0.05). ROC curve analysis showed that the areas under the curve (AUC) for predicting CAL in children with KD were 0.709 for the Egami score and 0.644 for the D-dimer/fibrinogen ratio, while the AUC for the combined prediction using the Egami score and D-dimer/fibrinogen ratio was 0.799. Conclusion: For children with KD, higher Egami scores and higher serum D-dimer/fibrinogen ratios increase the risk of developing CAL. Both can serve as predictive indicators, and their combined application has high predictive value for CAL complicating KD.