Predictors of intravenous immunoglobulin-resistant Kawasaki disease in children: a meta-analysis of 4442 cases.
Predictors of intravenous immunoglobulin-resistant Kawasaki disease in children: a meta-analysis of 4442 cases.
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儿童静脉注射免疫球蛋白耐药川崎病的预测因子：4442 例病例的荟萃分析
DOI：
10.1007/s00431-018-3182-2
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发表时间：
2018-08
影响因子：
3.6
通讯作者：
Lv H
中科院分区：
文献类型：
--
作者：
Li X;Chen Y;Tang Y;Ding Y;Xu Q;Sun L;Qian W;Qian G;Qin L;Lv H
本研究的目的是确定的临床特征和实验室因素，是预测静脉注射免疫球蛋白（IVIG）耐药的川崎病。检索了多个数据库中2002年1月至2017年4月发表的IVIG耐药川崎病相关研究。通过手动审查参考文献检索合格研究。使用Stata 12进行荟萃分析。计算几个指标的加权平均差和比值比及95%置信区间。纳入了28项研究，涉及26，260例患者，包括4442例IVIG耐药的川崎病患者和21，818例IVIG敏感的川崎病患者。荟萃分析显示，IVIG抵抗组的血沉（ESR）显著高于IVIG敏感组，IVIG抵抗组的血小板计数和血红蛋白水平显著低于IVIG敏感组。口腔黏膜改变、颈部淋巴结肿大、四肢肿胀、多形皮疹、症状出现后首次使用IVIG ≤ 4.0天的患者更容易出现IVIG耐药。结论：在症状发作后≤ 4.0天内首次给予IVIG可增加ESR，降低血红蛋白和血小板计数，口腔粘膜改变，颈部淋巴结病，四肢肿胀和多形皮疹是IVIG耐药川崎病的危险因素。已知内容：·最近有关该主题的报道涉及天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、γ-谷氨酰转移酶、总胆红素、白色细胞、血小板、红细胞沉降率（ESR）、多形核白细胞（PMN）、C反应蛋白（CRP）、脑钠肽前体（BNP）、白蛋白和钠作为IVIG耐药川崎病的危险因素;然而，目前还没有关于临床特征作为IVIG耐药预测因子的研究发表。最新消息：·这项荟萃分析确定了临床特征、症状发作后IVIG首次给药≤ 4.0天以及更全面的实验室指标（如血红蛋白）作为IVIG耐药川崎病的预测因子。
The purpose of this study was to identify the clinical features and laboratory factors that are predictive of intravenous immunoglobulin (IVIG)-resistant Kawasaki disease. Multiple databases were searched for relevant studies on IVIG-resistant Kawasaki disease published from January 2002 to April 2017. Eligible studies were retrieved by manual review of the references. Stata 12 was used for the meta-analysis. Weighted mean differences and odds ratios with 95% confidence intervals were calculated for several indices. Twenty-eight studies involving 26,260 patients comprising 4442 IVIG-resistant Kawasaki disease patients and 21,818 IVIG-sensitive Kawasaki disease patients were included. The meta-analysis showed that the erythrocyte sedimentation rate (ESR) in the IVIG-resistant group was significantly higher than that in the IVIG-sensitive group, and that platelet count and hemoglobin levels were significantly lower in the IVIG-resistant group. The patients with oral mucosa alterations, cervical lymphadenopathy, swelling of the extremities, polymorphous rash, and initial administration of IVIG ≤ 4.0 days after the onset of symptoms were more likely to be IVIG resistant.Conclusion: The initial administration of IVIG ≤ 4.0 days after the onset of symptoms increased ESR and decreased hemoglobin and platelet counts, oral mucosa alterations, cervical lymphadenopathy, swelling of the extremities, and polymorphous rash and are the risk factors for IVIG-resistant Kawasaki disease.What is Known:• Recent reports on this topic are about aspartate aminotransferase (AST), alanine aminotransferase (ALT), gammaglutamyl transferase, total bilirubin, white blood cells, platelets, erythrocyte sedimentation rate (ESR), polymorphonuclear leukocytes (PMN), C-reactive protein (CRP), pro-brain natriuretic peptide (BNP), albumin, and sodium as the risk factors in the IVIG-resistant Kawasaki disease; however, no studies have been published on clinical features as predictors of IVIG resistance.What is New:• This meta-analysis identified the clinical features, the initial administration of IVIG ≤ 4.0 days after the onset of symptoms, and much more comprehensive laboratory indicators, such as hemoglobin, as predictors of IVIG-resistant Kawasaki disease.
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影响因子：
37.8
作者：
Kobayashi, Tohru;Inoue, Yoshinari;Morikawa, Akihiro
通讯作者：
Morikawa, Akihiro
川崎疾病中初始静脉免疫球蛋白治疗失败的危险因素。
影响因子：
4.5
作者：
Cha S;Yoon M;Ahn Y;Han M;Yoon KL
通讯作者：
Yoon KL
影响因子：
5.1
作者：
Egami, Kimiyasu;Muta, Hiromi;Matsuishi, Toyojiro
通讯作者：
Matsuishi, Toyojiro
影响因子：
0.9
作者：
Hartas, Georgios A.;Hashmi, Syed Shahrukh;Gupta-Malhotra, Monesha
通讯作者：
Gupta-Malhotra, Monesha
影响因子：
1.4
作者：
Nakagama, Yu;Inuzuka, Ryo;Oka, Akira
通讯作者：
Oka, Akira