| ObjectiveTo investigate the clinical significance of serum sodium(Na)combined with serum albumin(ALB)in children with Kawasaki disease(KD).MethodsA total of 341 children with newly diagnosed KD who were hospitalized in the Department of Pediatrics of the first affiliated Hospital of Anhui Medical University from January 2017 to January 2022 were collected.The relevant information was extracted from the hospitalized medical records,and the subjects were selected according to the inclusion and exclusion criteria for retrospective analysis.According to the diagnostic criteria of KD,the patients were divided into complete KD(c KD)group and incomplete KD(i KD)group.According to the results of echocardiography,they were divided into CAL group(n = 33)and non-CAL group(n CAL group).According to the sensitivity to IVIG therapy,they were divided into IVIG sensitive group(n = 209)and IVIG nonsensitive group(n = 11).Collect the relevant information from the hospitalized medical records:(1)The age,sex and hot course of the children;(2)Blood test indexes: in the acute stage(before IVIG and aspirin treatment),the peripheral venous blood 2m L was taken on an empty stomach in the early morning,and the anticoagulant tube of EDTA was added to shake it upside down,and the blood routine(WBC,PLT,etc.)was detected immediately.At the same time,the serum of 3m L was collected to detect glutamic pyruvic transaminase(ALT),aspartate oxaloacetic transaminase(AST),total bilirubin(TB),albumin(ALB),C-reactive protein(CRP),procalcitonin(PCT)and serum sodium(Na),and 2m L was added to sodium citrate anticoagulant tube and shaken upside down to detect erythroc-yte sedimentation rate(ESR).SYSMEXXE-2100(F5192)automatic hematology analyzer was used to detect blood routine,Cobas6000 automatic biochemical analyzer was used to detect biochemical indexes,and Wechsler method was used to detect ESR.(3)The cardiac color ultrasound examination was completed by the doctor in the cardiac color ultrasound room of our hospital(instrument model: Philips EPIQ7C).For this study,the data were analyzed by SPSS26.0 statistical software.The measured data in accordance with the normal distribution are expressed as the mean ±standard deviation( ± ),and the two independent samples t-test is used to compare the two groups;the measurement data of non-normal distribution are expressed as the median(quartile spacing)[M(P25,P75)],and the rank sum test is used for comparison between the two groups.The counting data were expressed as a percentage(%),and the comparison between groups was conducted with the Chi-Square Test.The influencing factors of CAL were analyzed by single factor analysis.According to the results of single factor analysis,meaningful variables were selected for multi-factor Logistic regression analysis,and the independent risk factors of CAL were screened out.The subject working characteristic curve(Receiver operating characteristic curve,ROC curve)was drawn,and the area under the curve(AUC)was calculated.The cut-off point was the highest point of Jordan index.According to the cut-off point,the sensitivity and specificity of blood Na and blood ALB were calculated.The difference was statistically significant(P < 0.05).Results1.Univariate analysis showed that there were significant differences in blood Na,ALB,PLT,CRP and gender between CAL group and n CAL group.Compared with n CAL group,blood Na and ALB levels in CAL group were significantly lower,PLT and CRP levels were significantly higher,and male morbidity was higher(all P < 0.01).2.Univariate analysis showed that the levels of serum Na in cKD group and i KD group were significantly lower than those in i KD group,the level of ALB in c KD group was lower than that in i KD group,but there was no significant difference between the two groups,and the febrile course in i KD group was significantly longer than that in c KD group(all P<0.05).3.Univariate analysis of IVIG sensitive group and IVIG non-sensitive group showed that compared with IVIG sensitive group,the levels of Na and ALB in IVIG nonsensitive group were significantly lower,the fever duration was significantly longer,and TB was significantly higher than that in IVIG non-sensitive group(all P<0.05).4.Multivariate logistic regression analysis of the risk factors of KD complicated with CAL: with or without CAL as dependent variable,blood Na,ALB,PLT,CRP and gender as independent variables.The results showed that the decrease of blood Na and ALB levels and the increase of PLT and CRP levels were independent risk factors of KD complicated with CAL(all P<0.01).5.The analysis of ROC curve showed that the best cutoff value of blood Na for predicting KD combined with CAL was 133.95 mmol/L,the sensitivity was 84.8%,and the specificity was 77.0%.The area under the CAL curve(AUC)was 0.853(95%CI: 0.775,0.931,P<0.01).The best cut-off value of CAL predicted by ALB alone was 32.95 g / L,the sensitivity was 81.8%,and the specificity was 86.6%.The AUC of KD combined with CAL predicted by blood Na combined with ALB level was0.934(95%CI: 0.8860.983,P<0.01).ROC curve analysis showed that the diagnostic efficacy of blood Na combined with ALB level in predicting KD complicated with CAL was higher than that of blood Na or ALB alone.ConclusionThe levels of blood Na and ALB can be used as important indexes for early prediction of KD complicated with CAL.The combined detection of blood Na and ALB is more effective in the diagnosis of KD complicated with CAL and has higher predictive value. |
