Early recognition of coronary artery lesion in Kawasaki disease and its relationship with monocyte to HDL-C ratio
10.3969/j.issn.1000-484X.2024.11.023
- VernacularTitle:川崎病冠状动脉损害的早期识别及其与单核细胞与HDL-C比值的关系
- Author:
Shangming CHEN
1
;
Haiying HUANG
;
Aiqin JIN
;
Honglei GONG
Author Information
1. 南通大学附属医院儿科,南通 226001
- Keywords:
Kawasaki disease;
Coronary artery lesion;
Monocyte to HDL-C ratio;
Early recognition;
Relationship
- From:
Chinese Journal of Immunology
2024;40(11):2380-2385
- CountryChina
- Language:Chinese
-
Abstract:
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 regres-sion 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 cor-related with the degree of coronary artery dilatation in children with CAL(r=0.743,P=0.001).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%CI:1.329～6.431,P=0.003);Logis-tic 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×gender+0.181×ever time+1.064×MHR+0.459×WBC+0.146×NLR+0.211×CRP,P=e logit(P)/1+e logit(P),the AUC of this model was 0.874(95%CI:0.799～0.892),compared with the test set(AUC was 0.881,95%CI:0.785～0.913),the difference was not statistically sig-nificant(P>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.
