| Abstrakt: |
Objective: To investigate the early recognition of coronary artery lesions (CAL) in Kawasaki disease (KD) and its relationship with monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR). Methods: A total of 216 children with KD who were hospitalized in Affiliated Hospital of Nantong University from June 2019 to June 2022 were selected as the research subjects, and divided into training set (162 cases) and test set (54 cases). The clinical data of the children were collected, and the children in the training set were divided into the CAL group (45 cases) and the NCAL group (117 cases) according to the diagnostic results of echo-cardiography, and the differences in clinical data and laboratory test results were compared between the two groups ; Logistic regression analysis was used to analyze the risk factors of CAL in children with KD; Pearson was used to analyze the correlation between MHR and CAL in children with KD. According to the MHR quantile, the children in the CAL group were divided into low MHR group (=$0.28), medium MHR group (0.29-0.42) and high MHR group ( >0.43), and they were analyzed and compared. Cox regression model was used to analyze the relationship between MHR and CAL risk in children with KD, and a predictive model was constructed based on the independent risk factors of CAL in children with KD. Results:There were 162 KD children with fever, and summer was a high incidence period; compared with the NCAL group, the CAL group had statistically significant differences in age, gender, fever time, KD type, MHR, WBC, PLT, NLR, and CRP (all P<0.05) ; Pearson correlation analysis showed that MHR was positively correlated with the degree of coronary artery dilatation in children with CAL (r=0.743, P=0.00l). and the risk of CAL in the KD children in the high MHR group was significantly higher than that in the low MHR group (HR=2.857, 95%C/; 1.329-6.431, P=0.003); Logistic regression analysis showed that gender, fever time, MHR, WBC, NLR and CRP were independent risk factors for CAL in children with KD. A prediction model was constructed based on the independent risk factors of CAL; Logit(P) =1.342+0.359>0.05); the AUC of MHR for predicting CAL in children with KD was 0.796, the sensitivity was 0.896, and the specificity was 0.824, which could be used as an early predictor of CAL in children with KD. Conclusion: MHR has a certain predictive value in the diagnosis of CAL in children with KD, and can reflect the degree of CAL in children with KD to a certain extent. Therefore, it is necessary to pay attention to the changes of MHR in children with KD in clinical practice. [ABSTRACT FROM AUTHOR] |
