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[目的]探讨心电图和血小板参数变化在川崎病早期对冠状动脉(冠脉)病变的预测价值。[方法]对发病7d内的川崎病(KD)患儿63例进行心电图和血小板参数检查,同时做心脏彩色多普勒超声(心彩超)观察冠脉病变,在1个月内复查心彩超。将病例设为观察组(有冠脉病变)34例和对照组(无冠脉病变)29例。比较两组早期心电图和血小板参数的异常情况,评价单独或联合预测川崎病冠脉病变的敏感性、特异性、阳性预示值及阴性预示值。[结果]两组心电图和血小板参数变化差异有显著性,心电图变化预测冠脉病变的敏感性、特异性为82.4%和72.4%;血小板参数为76.5%和62.1%。两者联合预测的特异性高于单独预测(P<0.05),且有相对较高的阳性预示值。[结论]观察川崎病早期患儿的心电图和血小板参数变化,对川崎病冠脉病变的预测有一定临床价值,两者联合预测有较高特异性。
[Objective] To investigate the predictive value of changes of electrocardiogram and platelet parameters in coronary artery (coronary artery) in early Kawasaki disease. [Methods] The electrocardiogram and platelet parameters were examined in 63 children with Kawasaki disease (KD) within 7 days of onset. At the same time, coronary artery disease was observed by color Doppler sonography. The cases were divided into the observation group (with coronary lesions) 34 cases and the control group (no coronary lesions) 29 cases. The abnormal ECG and platelet parameters were compared between the two groups to evaluate the sensitivity, specificity, positive predictive value and negative predictive value of Kawasaki disease alone or in combination. [Results] The difference of electrocardiogram and platelet parameter between the two groups was significant. The changes of electrocardiogram were sensitive to coronary artery disease. The specificity was 82.4% and 72.4%. The platelet parameters were 76.5% and 62.1% respectively. The specificity of the joint prediction was higher than that of the single prediction (P <0.05), and there was a relatively higher positive predictive value. [Conclusion] The changes of electrocardiogram and platelet parameters in children with early Kawasaki disease may have some clinical value in the prediction of coronary artery disease in Kawasaki disease. The combination of the two is highly specific.