一种基于血清CHI3L1的诺米克图,用于预测川崎病儿童IVIG无反应
Jialin Zou1,2, Yan Duan1,2, Dinghua Luo1,2
1Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, 646000, Sichuan, China.
European journal of pediatrics
|January 6, 2026
概括
血清胆酶-3样蛋白1 (CHI3L1) 预测了川崎病 (KD) 中静脉注射免疫球蛋白 (IVIG) 的不反应. 一种结合CHI3L1和CRP的新型诺摩图提供了改善的不响应患者的早期识别.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 免疫学 免疫学 免疫学
- 生物标志物发现发现
背景情况:
- 川崎病 (KD) 是获得的儿科心脏病的主要原因.
- 在KD中,静脉注射免疫球蛋白 (IVIG) 不响应会增加冠状动脉病变的风险.
- 预测IVIG耐药性的现有生物标志物具有有限的概括性和性能.
研究的目的:
- 评估血清基因酶-3样蛋白1 (CHI3L1) 作为儿科KD患者IVIG无反应的预测因子.
- 开发和验证一个包含CHI3L1用于KDIVIG不响应的预测模型.
主要方法:
- 在IVIG输注前使用ELISA测量了152名KD儿童 (23名无响应者,129名响应者) 的血清CHI3L1水平.
- 后勤回归确定了独立的预测因素,并构建了一个名ogram.
- 模型性能使用AUC,校准图,DCA,CIC,NRI和IDI进行评估.
主要成果:
- 在IVIG无反应的KD患者中,血清CHI3L1水平显著更高.
- 多变量分析确定CHI3L1和C反应蛋白 (CRP) 是IVIG无反应的独立预测因素.
- 整合CHI3L1和CRP的诺米图实现了0.83的AUC,具有高灵敏度 (0.91) 和特异性 (0.67),显示出比单个标记物更好的预测准确性.
结论:
- 血清CHI3L1是一种新的,独立的预测IVIG在Kawasaki疾病的不响应.
- 结合CHI3L1和CRP的诺莫图显示出出色的预测性能和临床实用性.
- 这种名图可以作为一种实用工具,用于早期识别可能对IVIG治疗无反应的KD患者.
相关概念视频
Acute Kidney Injury IV: Diagnostic Studies and Prevention
256
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
256
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
185
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
185
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
231
Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
231
Dosage Regimen Designs: Nomograms and Tabulations
174
Nomograms and tabulations are vital tools used by clinicians to design accurate and individualized dosage regimens. These instruments provide a straightforward method for adjusting dosages based on individual patient characteristics, including age, weight, and physiological condition. The foundation of a drug's nomogram is population pharmacokinetic data collected and analyzed using specific models. This data simplifies complex equations, presenting them diagrammatically or tabularly for easy...
174
Acute Kidney Injury III: Clinical Manifestations
804
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
804
Acute Kidney Injury I: Introduction
562
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
562


