Auxiliary diagnostic value of coronary artery Z-value and other quadruple index model for mucocutaneous lymph node syndrome
Objective To explore the auxiliary diagnostic value of coronary artery Z-value combined with febrile duration,IL-6,CRP for mucocutaneous lymph node syndrome(also known as Kawasaki disease).Methods A total of 165 suspected cases of Kawasaki disease admitted in paediatric ward of Zhongshan Hospital Xiamen University from January 2017 to December 2022 were enrolled in this study.Among the 165 cases,83 were confirmed having Kawasaki disease(including in-complete Kawasaki disease),and the other 82 cases were excluded.Clinical data and coronary artery Z-value of the children were collected.Multivariate logistic regression was used to analyze the independent risk factors.A quadruple index model for the dis-ease was constructed.Receiver operating characteristic curve(ROC)analysis was used to calculate the area under the curve(AUC),and the optimal diagnostic threshold was determined by Youden index.Kappa value was used to evaluate the consis-tency between quadruple index diagnostic model and clinical diagnostic criteria.Results Coronary artery Z-value,febrile dura-tion,IL-6,CRP were the independent risk factors of Kawasaki disease.The optimal diagnostic threshold was 1.5 for coronary artery Z-value,5.5 d for febrile duration,31 pg/mL for IL-6 and 42 mg/L for CRP.The AUC of quadruple index diagnostic model was 0.960,Kappa value was 0.867.Its diagnostic value was higher than those of independent risk factors,and it has high consistency with clinical diagnostic criteria.Conclusion Coronary artery Z-value combined with febrile duration,IL-6 and CRP quadruple index model can effectively assist clinical diagnosis and reduce missed diagnosis,and provide reference for impro-ving the efficiency of Kawasaki disease diagnosis.
mucocutaneous lymph node syndromecoronary arteryZ valuefebrile durationinterleukin-6C-reactive protein
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