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한국인에서 면역글로불린-저항성 가와사키병 환자의 예측
Prediction of Intravenous Immunoglobulin Nonresponse Kawasaki Disease in Korea

소아감염 2014년 21권 1호 p.29 ~ p.36

최명현(Choi Myung-Hyun) - 연세대학교 의과대학 소아과학교실
박청수(Park Chung-Soo) - 연세대학교 의과대학 소아과학교실
김동수(Kim Dong-Soo) - 연세대학교 의과대학 소아과학교실
김기환(Kim Ki-Hwan) - 연세대학교 의과대학 소아과학교실

Abstract

Purpose: The objective of this study was to find the predictors and generate a prediction scoring model of nonresponse to intravenous immunoglobulin in patients with Kawasaki disease.

Methods: We examined 573 children diagnosed with KD at the Severance Children’s Hospital between January 2009 and december 2012. We retrospectively reviewed their medical records. These patients were divided into 2 groups; the experimental group (N=433) and the validation group (N=140). Each group were divided into 2 groups the intravenous immunoglobulin nonresponders and the responders. Multivariate logistic regression analysis identified predictive factors of intravenous immunoglobulin nonresponders which make predictive scoring model. We practice internal validation and external validation.

Results: Multivariate logistic regression analysis identified male, cervical lymphadenopathy, changes of the extremities, platelet, total bilirubin, alkaline phophatase, lactate dehydrogenase, C-reactive protein as significant predictors for nonresponse to intravenous immunoglobulin. We generated prediction score assigning 1 point for (1) male, (2) cervical lymphadenopathy, (3) changes of the extremities, (4) platelet (≤368,000/mm3), (5) total bilirubin (≥0.4 mg/dL), (6) alkaline phophatase (≥227 IU/L), (7) lactate dehydrogenase (≥268 IU/L), (8) C-reactive protein (>77.1 mg/dL). Using a cut-off point of 4 and more with this prediction score, we could identify the intravenous immunoglobulin nonresponder group. Sensitivity and specificity were 52.5% and 82.4% in experimental group and 37.8% and 81.8% in validation group, respectively.

Conclusion: Our predictive scoring models had high specificity and low sensitivity in Korean patients. Therefore it is useful in predicting nonresponse to intravenous immunoglobulin with Kawasaki disease.

키워드

Kawasaki disease, Nonresponse, Intravenous immunoglobulin, Prediction, Risk factors

KMID : 0605820140210010029

원문 및 링크아웃 정보

등재저널 정보

주제코드

주제명(Target field)

연구대상(Population)

연구참여(Sample size)

대상성별(Gender)

질병특성(Condition Category)

연구환경(Setting)

연구설계(Study Design)

연구기간(Period)

중재방법(Intervention Type)

중재명칭(Intervention Name)

키워드(Keyword)

유효성결과(Recomendation)

연구비지원(Fund Source)

근거수준평가(Evidence Hierarchy)

출판년도(Year)

참여저자수(Authors)

대표저자

DOI

KCD코드

ICD 03

건강보험코드

한국인에서 면역글로불린-저항성 가와사키병 환자의 예측 Prediction of Intravenous Immunoglobulin Nonresponse Kawasaki Disease in Korea

Abstract

키워드

한국인에서 면역글로불린-저항성 가와사키병 환자의 예측
Prediction of Intravenous Immunoglobulin Nonresponse Kawasaki Disease in Korea