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《Journal of Qingdao University(Medical Sciences)》 2018-03
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DIAGNOSTIC VALUE OF FIVE DIAGNOSTIC CRITERIA FOR KAWASAKI DISEASE:A COMPARATIVE ANALYSIS

LI Ruihan;WANG Benzhen;MAO Chenggang;NIE Na′na;LIN Yi;LI Zipu;Heart Center,The Affiliated Women and Children Hospital of Qingdao University;  
Objective To compare the diagnostic value of different diagnostic criteria for Kawasaki disease(KD).Methods A total of 300 children who visited the hospital due to"pyrexia"and were suspected of KD were enrolled,and different diagnostic criteria were used for diagnosis.With clinical and laboratory examination results,echocardiographic findings,and followup results as the gold standard for a confirmed diagnosis,the diagnostic value of different diagnostic criteria was compared. Results Based on the clinical and laboratory examination results,echocardiographic findings,and follow-up results,215 children were diagnosed with typical KD,38 were diagnosed with atypical KD,and 47 were excluded.As for typical KD,the diagnostic specificity was 100%for international criteria,91.5%for self-made criteria,85.1%for domestic criteria,76.6%for Japanese criteria,and 74.5%for American criteria.Self-made criteria had the highest sensitivity of 96.8% and the highest accuracy rate of 92.3%,followed by domestic criteria and American criteria,and international critiera had a sensitivity of 54.9% and an accuracy rate of62.0%.As for atypical KD,self-made criteria had the highest sensitivity of 50.0%,specificity of 98.5%,and accuracy rate of92.3%,followed by American criteria and domestic criteria.There was a significant difference in Youden index between self-made criteria and domestic/international/Japanese/American criteria(U=2.50-4.30,P0.01). Conclusion Self-made criteria for KD improves the diagnostic sensitivity and accuracy rate of KD and do not affect diagnostic specificity,and therefore,it is more suitable for the diagnosis of pediatric KD in China.
【Fund】: 青岛市医疗卫生优秀人才培养项目资助(青卫科教字[2017]4号)
【CateGory Index】: R725.4
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