A novel scoring system based on sIL-2R for predicting IVIG resistance in Chinese children with KD.

IF 2.8 3区医学 Q1 PEDIATRICS Pediatric Rheumatology Pub Date : 2024-08-18 DOI:10.1186/s12969-024-01015-w

Yuan-Yuan Zeng, Su-Yue Zhu, Kang-Kang Xu, Lian-Fu Ji, Yu-Qi Wang, Yi Chen, Feng Chen, Shi-Wei Yang

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Abstract

Objective: This study aimed to develop a novel scoring system utilizing circulating interleukin (IL) levels to predict resistance to intravenous immunoglobulin (IVIG) in Chinese patients with Kawasaki disease (KD). We further compared this scoring system against six previously established scoring methods to evaluate its predictive performance.

Methods: A retrospective analysis was conducted on KD patients who were treated at the cardiovascular medical ward of our institution from January 2020 to December 2022. Six scoring systems (Egami, Formosa, Harada, Kobayashi, Lan and Yang) were analyzed, and a new scoring system was developed based on our data.

Results: In our study, 521 KD patients were recruited, 42 of whom (8.06%) were identified as resistant to IVIG. Our study indicated that IVIG-resistant KD patients were at an increased risk for the development of coronary arterial lesions (CALs) (P = 0.001). The evaluation of IVIG resistance using various scoring systems revealed differing levels of sensitivity and specificity, as follows: Egami (38.10% and 88.52%), Formosa (95.24% and 41.13%), Harada (78.57% and 43.22%), Kobayashi (66.67% and 74.95%), Lan (66.67% and 73.49%), and Yang (69.05% and 77.24%). Our novel scoring system utilizing sIL-2R demonstrated the highest sensitivity and specificity of 69.29% and 83.91%, respectively, and calibration curves indicated a favorable predictive accuracy of the model.

Conclusion: Our newly developed scoring system utilizing sIL-2R demonstrated superior predictive performance in identifying IVIG resistance among Chinese patients with KD.

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基于 sIL-2R 的新型评分系统用于预测中国 KD 患儿对 IVIG 的耐药性。

研究目的本研究旨在利用循环白细胞介素（IL）水平开发一种新型评分系统，以预测中国川崎病（KD）患者对静脉注射免疫球蛋白（IVIG）的耐受性。我们进一步将该评分系统与之前建立的六种评分方法进行了比较，以评估其预测性能：我们对 2020 年 1 月至 2022 年 12 月期间在我院心血管内科病房接受治疗的 KD 患者进行了回顾性分析。分析了六种评分系统（Egami、Formosa、Harada、Kobayashi、Lan 和 Yang），并根据我们的数据开发了一种新的评分系统：我们的研究共招募了 521 名 KD 患者，其中 42 人（8.06%）被确定为对 IVIG 耐药。我们的研究表明，对 IVIG 耐药的 KD 患者发生冠状动脉病变 (CAL) 的风险更高（P = 0.001）。使用不同的评分系统对 IVIG 耐药性进行评估后发现，其敏感性和特异性水平各不相同，具体如下：Egami（38.10% 和 88.52%）、Formosa（95.24% 和 41.13%）、Harada（78.57% 和 43.22%）、Kobayashi（66.67% 和 74.95%）、Lan（66.67% 和 73.49%）和 Yang（69.05% 和 77.24%）。我们利用 sIL-2R 的新型评分系统显示出最高的灵敏度和特异性，分别为 69.29% 和 83.91%，校准曲线表明该模型具有良好的预测准确性：我们新开发的利用 sIL-2R 的评分系统在识别中国 KD 患者的 IVIG 耐药性方面表现出了卓越的预测性能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Rheumatology PEDIATRICS-RHEUMATOLOGY

CiteScore

4.10

自引率

8.00%

发文量

审稿时长

>12 weeks

期刊介绍： Pediatric Rheumatology is an open access, peer-reviewed, online journal encompassing all aspects of clinical and basic research related to pediatric rheumatology and allied subjects. The journal’s scope of diseases and syndromes include musculoskeletal pain syndromes, rheumatic fever and post-streptococcal syndromes, juvenile idiopathic arthritis, systemic lupus erythematosus, juvenile dermatomyositis, local and systemic scleroderma, Kawasaki disease, Henoch-Schonlein purpura and other vasculitides, sarcoidosis, inherited musculoskeletal syndromes, autoinflammatory syndromes, and others.