Effect of Coagulation Index Changes on the Occurrence of Intravenous Immunoglobulin Resistance in Children with Kawasaki Disease
Objective To explore the influence of coagulation index changes on intravenous immunoglobulin resistance in children with Kawasaki disease(KD),and to provide experience for improving the prognosis of children.Methods A prospective study was conducted in this study.180 children with KD who were admitted to our Hospital from April 2018 to April 2022 were included.All children were treated with immunoglobulin.Before treatment,the levels of serum D-dimer(D-D)and blood coagulation(activated partial thromboplastin time(APTT),thrombin time(TT),prothrombin time(PT)and fibrinogen(FIB))were measured,and the baseline data questionnaire was designed to record the data needed for the study.After treatment,the incidence of intravenous immunoglobulin resistance in KD children was counted and divided into occurrence group and non occurrence group according to the occurrence of immunoglobulin resistance.The possible factors were included,and the impact of changes in coagulation indexes on the occurrence of venous immunoglobulin resistance in children was analyzed,to explore its predictive value for the occurrence of venous immunoglobulin resistance in children with KD.Results Among 180 cases of KD treated with immunoglobulin,41 cases(22.78％)developed venous immunoglobulin resistance.The serum D-D,FIB,interleukin-6(IL-6)and percentage of neutrophils(NEUT％)in the patients in the occurrence group were higher than those in the non occurrence group before treatment(P＜0.05).Comparison of APTT,TT,PT and other baseline data between the two groups(P＞0.05).Logistic regression analysis showed that high levels of serum D-D,FIB,IL-6 and NEUT％before treatment were the risk factors for intravenous immunoglobulin resistance in KD children(OR＞1,P＜0.05).The ROC curve was drawn.The results showed that the area under the curve(AUC)of serum D-D,serum FIB and combined prediction of venous immunoglobulin resistance in KD children were≥0.07,and the combined prediction value was the highest.Conclusion The high level of serum D-D and FIB before treatment is a risk factor for KD children with venous immunoglobulin resistance.The combined detection of the two levels can be used to predict and evaluate the risk of venous immunoglobulin resistance in children with KD.
万方数据
维普
