【摘要】 目的 分析常规实验室检查指标在川崎病早期诊断中的应用价值。方法 选取川崎病患儿280例纳入研究组，非川崎病发热患儿104例纳入对照组。收集两组患儿性别、年龄、病程、住院时间等资料，收集患儿血常规指标、血生化指标、C反应蛋白检测资料。分别采用单因素分析和多因素Logistic回归分析川崎病的影响因素。绘制受试者工作特征（ROC）曲线，评估血常规指标、血生化指标、C反应蛋白对川崎病的诊断效能。结果 研究组中性粒细胞计数、白细胞计数、谷氨酸氨基转移酶、总胆红素、C反应蛋白、血肌酐、乳酸脱氢酶、总胆汁酸、血小板高于对照组，前白蛋白、血氯、血钾、血钠低于对照组（P均<0.05）。以是否确诊川崎病为因变量，以单因素分析差异有统计学意义的指标作为自变量，进行Logistic回归分析，结果显示血小板、血肌酐、总胆汁酸、血钠是川崎病发病的独立影响因素（P均<0.05）。ROC曲线分析结果显示，血小板、血肌酐、总胆汁酸、血钠联合检测诊断川崎病的灵敏度0.90、特异度0.99、ROC曲线下面积0.985(95%CI:0.967～0.995)，高于各项指标单独检测。结论 常规实验室检查指标中，血小板、血肌酐、总胆汁酸、血钠是川崎病的独立影响因素，这些指标异常者应考虑川崎病可能性。血小板、血肌酐、总胆汁酸、血钠联合检测诊断川崎病的效能较高。更多还原

【Abstract】 Objective To explore the value of routine laboratory test indicators in the early diagnosis of Kawasaki disease. Methods A total of 280 children with Kawasaki disease were enrolled in the study group, and 104 feverish children without Kawasaki disease were included in the control group. Data including gender, age, disease course, and length of hospital stay were collected from both groups, along with data of blood routine indicators, blood biochemical indicators, and C-reactive protein(CRP) tests. Univariate analysis and multivariate Logistic regression analysis were used to identify the influencing factors of Kawasaki disease. Receiver operating characteristic(ROC) curves were plotted to evaluate the diagnostic efficacy of blood routine indicators, CRP, and blood biochemical indicators for Kawasaki disease. Results Compared with the control group, the study group had higher levels of neutrophil count, white blood cell count, alanine aminotransferase, total bilirubin, CRP, serum creatinine, lactate dehydrogenase, total bile acid, and platelets, while lower levels of prealbumin, blood chlorine, blood potassium, and blood sodium(all P<0. 05). Taking the confirmation of Kawasaki disease as the dependent variable and the indicators with statistically significant differences in univariate analysis as independent variables, Logistic regression analysis showed that platelets, serum creatinine, total bile acid, and blood sodium were independent influencing factors for Kawasaki disease(all P<0. 05). ROC curve analysis results revealed that the combined detection of platelets, serum creatinine, total bile acid, and blood sodium for diagnosing Kawasaki disease had a sensitivity of 0. 90, a specificity of 0. 99, and an area under the ROC curve(AUC) of 0. 985(95% CI: 0. 967-0. 995), which was higher than that of the individual detection of each indicator. Conclusions Among common laboratory test indicators, platelets, serum creatinine, total bile acid, and blood sodium are independent influencing factors for Kawasaki disease. Children with abnormal levels of these indicators should be considered for the possibility of Kawasaki disease. The combined detection of platelets, serum creatinine, total bile acid, and blood sodium has high efficacy in diagnosing Kawasaki disease.更多还原