【摘要】 目的 探讨AST/ALT比值（AAR）与川崎病（KD）并发冠状动脉病变（CAL）的相关性。方法 选择2010年1月至2019年12月嘉兴市第二医院收治的KD患儿461例，根据有无CAL，将患儿分为CAL组122例和无CAL组339例。比较两组患儿的临床资料，采用logistics回归分析KD患儿并发CAL的危险因素，采用ROC曲线评价AAR对KD并发CAL的预测价值。结果 CAL组年龄<6个月比例、起病到确诊时间、应用静脉注射免疫球蛋白（IVIG）治疗时病程>10 d比例、CRP和D-二聚体高于无CAL组，AAR低于无CAL组，差异均有统计学意义（均P<0.05）。logistics回归分析显示，年龄<6个月、应用IVIG治疗时病程>10 d、D-二聚体和AAR均为KD并发CAL的危险因素（均P<0.05）。ROC曲线分析显示，AAR预测KD并发CAL的最佳预测值为1.49,AUC为0.730，灵敏度和特异度分别为0.791和0.680。结论 AAR与KD并发CAL密切相关，AAR≤1.49的KD患儿CAL发生率升高。更多还原

【Abstract】 Objective To explore the association of aspartate aminotransferase to alanine aminotransferase ratio(AAR with coronary artery lesion(CAL) in children with Kawasaki disease(KD). Methods Clinical data of 461 KD children in Jiaxing Second Hospital from January 2010 to December 2019 were retrospectively analyzed, including 122 cases with CAL(CAL group) and 339 cases without CAL(non-CAL group) based on the results of the echocardiogram. The clinical and laboratory findings were compared between the two groups. Multivariate logistic regression analysis was used to identify risk factors of CAL in KD patients. Receiver operating characteristic(ROC) curve was used to evaluate the value of AAR for predicting CAL in children with KD. Results The proportion of children aged<6 months, the time from illness onset to diagnosis, proportion of children starting treatment with IVIG >10 days from illness onset, C-reactive protein and D-dimer levels in the CAL group were significantly higher than those in the non-CAL group, while AAR was significantly lower in CAL group(all P<0.05). Multivariate logistic regression analysis showed that age<6 months, starting treatment with IVIG >10days from illness onset, D-dimer level and AAR were independent risk factors of CAL in children with KD(all P<0.05). The ROC curve analysis revealed that the best AAR cut-off value for predicting CAL was 1.49 and the area under the curve was0.730 with sensitivity and specificity of 0.791 and 0.680, respectively. Conclusion AAR is closely related to occurrence of CAL in children with KD. KD Children with AAR≤1.49 are more likely to develop CAL.更多还原