Harada评分预测川崎病冠状动脉病变的临床意义

目的 探讨Harada评分对中国人群样本中川崎病（KD）合并冠状动脉病变高危因素判断的临床价值。方法 参照KD诊断标准及Harada评分标准，回顾性分析187例KD息儿发病10d内白细胞（WBC）计数、红细胞压积（HCT）、C反应蛋白（CRP）、发热天数、心电图及超声心动图等各项指标；采用χ^2检验和多元回归分析，分别检验上述因素与KD合并冠脉损害的相关性；比较冠脉损害组与非冠脉损害组Harada评分的差异。结果发病10d内单因素分析发病年龄、WBC计数、HCT、CRP、心电图改变及发热天数与KD合并冠脉损害有密切相关性。多因素分析结果显示，发病10d内CRP、发热天数与KD合并冠脉损害的发生独立相关。发生冠脉损害患儿Harada评分的平均分高于无冠脉损害者。结论 Harada评分可作为川崎病冠状动脉病变的一项预见性指标，也可作为中国人群川崎病患者早期是否应用静脉丙球的筛选指标。

Use of Harada score in the prediction of coronary arterial lesions in Kawasaki disease

Objectives To determine the predictive value of Harada score for high risk factors of Kawasaki disease (KD)complicated with coronary arterial lesions in Chinese. Methods Referring to the diagnostic criteria of KD and Harada scoring system,187 children with KD within 10 days of diagnosis were included in this study. Leucocyte counting,hematocrit,C-reactive protein,days of fever,electrocardiogram and echocardiogram. Chi-square test and multiple regression analysis were used to determine the correlation between factors mentioned above and KD complicated with coronary arterial lesions. Difference of Harada score was determined in the groups with and without coronary arterial lesions. Results Single factor analysis showed that KD complicated with coronary arterial lesions within 10 days was closely correlated with factors including age,leucocyte counting,hematocrit,C-reactive protein,days of fever,and electrocardiogram. Multivariate analysis showed that KD complicated with coronary arterial lesions with 10 days was independently correlated with C-reactive protein or days of fever. The average level of Harada score of the group with coronary arterial lesions was higher than the group without lesions. Conclusions Harada score could be used not only to predict coronary arterial lesions in KD,but also to decide whether intravenous immune globulin therapy should be administrated in the early stage of KD in Chinese population.