[1]李瑞菡,王本臻,毛成刚,等. 川崎病5种诊断标准诊断价值的比较[J].青岛大学学报(医学版),2018,54(03 ):342-346,350.[doi:10.11712/jms201803021]
 LI Ruihan,WANG Benzhen,MAO Chenggang,et al. DIAGNOSTIC VALUE OF FIVE DIAGNOSTIC CRITERIA FOR KAWASAKI DISEASE: A COMPARATIVE ANALYSIS[J].JOURNAL OF QINGDAO UNIVERSITY (MEDICAL SCIENCES),2018,54(03 ):342-346,350.[doi:10.11712/jms201803021]
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 川崎病5种诊断标准诊断价值的比较()
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《青岛大学学报(医学版)》[ISSN:2096-5532/CN:37-1217/R]

卷:
第54卷
期数:
2018年03 期
页码:
342-346,350
栏目:
出版日期:
2018-05-29

文章信息/Info

Title:
 DIAGNOSTIC VALUE OF FIVE DIAGNOSTIC CRITERIA FOR KAWASAKI DISEASE: A COMPARATIVE ANALYSIS
作者:
 李瑞菡12王本臻1毛成刚2聂娜娜2林毅2李自普1
 青岛大学,山东 青岛 266034 1 附属青岛市妇女儿童医院心脏中心;2 附属医院心肾免疫儿科
Author(s):
 LI Ruihan WANG Benzhen MAO Chenggang NIE Na′na LIN Yi LI Zipu
 Heart Center, The Affiliated Women and Children Hospital of Qingdao University, Qingdao 266034, China
关键词:
 黏膜皮肤淋巴结综合征参考标准诊断儿童
Keywords:
 mucocutaneous lymph node dyndrome reference standards diagnosis child
分类号:
R725.5
DOI:
10.11712/jms201803021
文献标志码:
A
摘要:
 目的 比较川崎病(KD)不同诊断标准的诊断价值。
方法 对以“发热”就诊、临床拟诊为KD的300例病儿,按照不同标准分别进行诊断。以经临床和实验室检查、心脏超声和随访最后确诊为金标准,比较不同诊断标准的诊断价值。
结果 经临床、实验室检查、心脏超声和随访最后确诊典型KD病儿215例,不典型KD病儿38例,排除KD病儿47例。对于典型KD,国际标准的诊断特异度为100%,自拟标准、国内标准、日本标准、美国标准的诊断特异度分别为91.5%、85.1%、76.6%、74.5%;但自拟标准的灵敏度及准确率最高,分别为96.8%和92.3%,其次为国内标准和美国标准,而国际标准仅分别为54.9%和62.0%。对于不典型KD,自拟标准的灵敏度、特异度、准确率均为最高,分别为50.0%、98.5%、92.3%,其次为美国标准和国内标准。自拟标准与国内标准、国际标准、日本标准和美国标准的Youden指数差异均有显著性(U=2.50~4.30,P<0.01)。
结论 自拟标准在不影响诊断特异性的前提下提高了KD的诊断敏感性和准确率,更适合我国小儿KD的诊断。
Abstract:
 Objective To compare the diagnostic value of different diagnostic criteria for Kawasaki disease (KD).
Methods A total of 300 children who visited the hospital due to “pyrexia” and were suspected of KD were enrolled, and different diagnostic criteria were used for diagnosis. With clinical and laboratory examination results, echocardiographic findings, and follow-up results as the gold standard for a confirmed diagnosis, the diagnostic value of different diagnostic criteria was compared.
Results Based on the clinical and laboratory examination results, echocardiographic findings, and follow-up results, 215 children were diagnosed with typical KD, 38 were diagnosed with atypical KD, and 47 were excluded. As for typical KD, the diagnostic specificity was 100% for international criteria,91.5% for self-made criteria, 85.1% for domestic criteria, 76.6% for Japanese criteria, and 74.5% for American criteria. Self-made criteria had the highest sensitivity of 96.8% and the highest accuracy rate of 92.3%, followed by domestic criteria and American criteria, and international critiera had a sensitivity of 54.9% and an accuracy rate of 62.0%. As for atypical KD, self-made criteria had the highest sensitivity of 50.0%, specificity of 98.5%, and accuracy rate of 92.3%, followed by American criteria and domestic criteria. There was a significant difference in Youden index between self-made criteria and domestic/international/Japanese/American criteria (U=2.50-4.30,P<0.01).
Conclusion Self-made criteria for KD improves the diagnostic sensitivity and accuracy rate of KD and do not affect diagnostic specificity, and therefore, it is more suitable for the diagnosis of pediatric KD in China.
更新日期/Last Update: 2018-06-05