The Z Scores Study Of Liner Regression Equation Evaluation Of Kawasaki Disease Combined With Coronary Artery Lesion

Objective To analysis the diversification of Z scores according to 2 dimension Echocardiography, the difference of Z scores and the individual body surface area of children during the evaluation of coronary artery of Kawasaki disease, provide a accurate and reliable evaluation method of coronary artery diameter for the earlier Diagnosis of coronary artery aneurysm.Methods 1. Clinical material of the cases group:1040 cases of children who were diagnosed as KD in Tianjin Children's Hospital from January 1997 to December 2009, the ages of the children were from 3 month to 5 years,the average age was 2.15±1.84. patients were divided into 5 groups (-1,-2,-3,-4,-5 years old). the whole children all met the diagnostic criteria of the Kawasaki disease combinated with coronary artery aneurysm of the American Heart Association.117 cases of Kawasaki disease with coronary artery lesion met the American Heart Association and the Japanese diagnostic criteria of pediatric Kawasaki disease combinated with coronary artery aneurysms. Coronary artery lesion group:coronary artery dilatation; coronary artery aneurysm group, patients were divided into 5 groups (-1,-2,-3,-4,-5 years old).2. Clinical material of the contral group:125 patients who had no clinical, electrocardiographic, chest x-ray, or echocardiographic evidence of congenital or acquired cardiac disease in Tianjin Children's hospital from March 2010 to April 2010 as the normal control group.there were 80 boys and 45 girls in the group,the average age were 1.95±1.43.3. Eestablished the linear regression equation of body weight(BW),BSA (in-dependent variable) and coronary artery diameter (dependent variable) Y=β1+β2(BW),Y=β1+β2(BSA) and the linear regression equation of independent variable LN (BW),LN (BSA)and dependent variable LN(Y), LN(Y)=β3+β4LN (BSA)。Calculated the mean square error (MSE), regression coefficient (β), adjusted coeffici-ent of determination (Ra2), determined the best regression equation. Results 1. The more common onset age of KD was 3 years(77.99%).Among the 117 cases of coronary injured patients,53 cases belonging to the Coronary artery dilatation group and 64 cases were classified as the coronary artery aneurysm group.the average age of the whole group was 1.39±1.16. The involvement of the Left main coronary artery (LMCA) was in 44 cases(37.60%),while the paroximal right coronary artery was in 29 (24.79%),and the Left anterior descending artery was 7 cases,and 29 (24.79%)cases of Bilateral coronary artery (DCA).there were 37(31.62%) cases belonging to little coronary artery aneurysm, 26(22.22%)cases met the medium coronary artery aneurysm criteria,1 case of large coronary artery aneurysm, The involvement of the Left main coronary artery (LMCA) was in 50 cases(42.74%),while the paroximal right coronary artery was in 39 (33.33%),and the Left anterior descending artery was 16(13.68%) cases,and 27 (23.08%)cases of Bilateral coronary artery (DCA).2. Body weight, BSA and tight and left coronary artery diameter was positively correlated(r=0.657,P=0.001, r=0.722,P=0.001). The regression model of body weight,body surface area and coronary artery diameter:LN(RCA)=0.243*LN(body weight), LMCA＝1.456 +0.042*(body weight)。LN(RCA)=0.734+0.305*LN(BSA), LN(LMCA)=0.881+ 0.334*LN(BSA).3. The RCA,LMCA Z scores mean rank of coronary artery lesion,coronary artery dialation,coronary artery aneurysm (LNBSA as the independent variable) was179.44,178.94; 143.24,147.91; 36.00,31.33,31.00,30.20,30.40, 36.00,30.42,31.00,26.50,27.30 while the RCA,LMCAZ scores mean rank of the control group was 67.26,67.74; 66.72,64.74; 13.00,13.08,13.00,13.12,13.04,13.00,13.52,13.00,14.60,14.28,There was significant statistic difference between the two groups(P<0.05).4. The positive diagnosis rate of the coronary artery aneurysm of RCA according to 2 dimension echocardiography evaluation methods of coronary artery diameter (which be divided into 5 groups according to age) was 6.59%,2.65%,2.34%,6.87-%,9.18%, while according to Z scores method the rate was 12.40%,5.90%,5.14-%,9.16%,10.20% respectively, There was significant statistic difference between the groups between less than 1 age group,1-2age group,2-3age group, but there was not significant statistic difference between the groups between 3-4age group,4-5age group. There was significant statistic difference by the Z scores method and the 2 dimension echocardiography evaluation methods between the groups between-1 age group,-2age group,while there were not significant statistic difference bet-ween the other groups.Conclution 1. There was a higher incidence of coronary artery lesions in KD from 10-20 days, the higher risk age was 1-2 years old, the main coronary artery lesions was LMCA,RCA and bilateral,while the rate of LAD was lower2. Two-dimensional ultrasound image through Z scores of post-processing highlight the individual differences by Weight, BSA and other important factors. Compared with two-dimensional measurement, Z scores can increase the diagnosis rate of coronary dilation and coronary artery aneurysms. We can improve the diagnostic rate of RCA by 5.8%, LMCA by 7.7% of the -1groups,while We can improve the diagnostic rate of RCA by 3.3%, LMCA by 5.0% of the -2groups.3. Body weight, BSA and tight and left coronary artery diameter was positively correlated((r=0.657,P=0.001,r=0.722,P=0.001)4.The RCA,LMCA Z scores of coronary artery lesion,coronary artery dialation,coronary artery aneurysm was greater than the control group respectively. The positive diagnosis rate of the coronary artery aneurysm according to Z scores methods of coronary artery diameter was greater than the traditional evaluation methods, whereas there was not difference between groups of 3-5 years old according this two methods.