CALLY指数在小儿川崎病冠状动脉损伤及预后评估中的价值
收稿日期: 2025-09-01
录用日期: 2026-03-18
网络出版日期: 2026-04-21
基金资助
河北省医学科学研究课题计划资助(20231174)
The Evaluation Value of CALLY Index for Coronary Artery Lesions and Prognosis in Children with Kawasaki Disease
Received date: 2025-09-01
Accepted date: 2026-03-18
Online published: 2026-04-21
目的:探讨CALLY指数对小儿典型性川崎病(KD)合并冠状动脉损伤(coronary artery lesions,CAL)及其预后的评估价值。方法:回顾性分析2021年6月至2025年6月就诊于河北省儿童医院的287例KD患儿,其中无冠状动脉损伤患儿(CAL-组)241例,合并CAL患儿(CAL+组)46例(治疗8周内冠状动脉恢复组29例,治疗8周冠状动脉持续扩张组17例),检测其外周全血血常规、血清白蛋白(serum albumin,ALB)、血清C-反应蛋白(C-reactive protein,CRP)等指标,评估上述指标对冠状动脉损伤的指示作用以及对预后的影响。结果:CAL+组KD患儿淋巴细胞(LYM)、ALB及CALLY指数均低于CAL-组,而CRP则高于CAL-组,差异均有统计学意义(P<0.01);CAL+ 8周持续扩张组及CAL+ 8周内恢复组与CAL-组比较,在急性期、临床恢复期、IVIG治疗后4周、IVIG治疗后8周等时期皆持续减低,而CAL+ 8周持续扩张组与CAL+ 8周内恢复组比较,在急性期、临床痊愈期及IVIG治疗后8周,指标减低更为显著,差异具有统计学意义(P<0.05)。结论:CALLY指数可作为KD急性期产生CAL的早期有效预测指标,且在KD合并CAL的预后评估中具有敏感指示作用。
高红亮
,
赵俊山
.
CALLY指数在小儿川崎病冠状动脉损伤及预后评估中的价值
Objective: To explore the evaluation value of indicators such as the CALLY index for the coronary artery lesions and prognosis in children with typical Kawasaki disease.Methods: A retrospective analysis was conducted on 287 children with typical Kawasaki disease (KD) who were treated at Hebei Children's Hospital from June 2021 to June 2025. Among them, there were 241 children without coronary artery lesions (CAL-) and 46 children with CAL(CAL+,29 cases in the group with coronary artery recovery within 8 weeks of treatment and 17 cases in the group with persistent coronary artery dilation at 8 weeks of treatment). The peripheral whole-blood routine, serum protein quantification, serum C-reactive protein and other indicators were detected to evaluate the indicative role of the above indicators in coronary artery lesions and their impact on prognosis.Results: In children with KD in the CAL+ group, the levels of lymphocytes (LYM), serum albumin (ALB), and the CALLY index were significantly lower than those in the CAL- group, while the level of C-reactive protein (CRP) in the CAL+ group was significantly higher than that in the CAL- group, and the differences were statistically significant (P<0.01); Compared with the CAL- group, the CAL+ 8-week continuous dilation group and the CAL+ recovery within 8 weeks group showed continuous reduction during the acute phase, clinical recovery phase, 4 weeks after IVIG treatment, 8 weeks after IVIG treatment and other periods. When comparing the CAL+ 8-week continuous dilation group with the CAL+ recovery within 8 weeks group, it was found that the reduction was more significant during the acute phase, clinical convalescence phase and 8 weeks after IVIG treatment (P<0.05).Conclusion: The CALLY index can serve as a good early predictive indicator for the development of CAL in the acute phase of KD, and it plays a sensitive indicative role in the assessment of the prognosis of KD complicated with CAL.
[1] Jone PN, Tremoulet A, Choueiter N, et al. Update on diagnosis and management of Kawasaki disease: a scientific statement from the American Heart Association[J].Circulation, 2024, 150(23): 481-500.
[2] Kuo HC. Diagnosis, progress, and treatment update of Kawasaki disease[J].Int J Mol Sci, 2023, 24(18):16.
[3] 陕西省川崎病诊疗中心/陕西省人民医院儿童病院,国家儿童医学中心/首都医科大学附属北京儿童医院,上海交通大学医学院附属儿童医院.中国儿童川崎病诊疗循证指南(2023年)[J].中国当代儿科杂志,2023, 25(12): 1198-1210.
[4] Goel AR, Yalcindag A. An update on Kawasaki disease[J].Curr Rheumatol Rep, 2024,27(1):4.
[5] Zhao J, Ma Y, Xin L, et al. Impact of intravenous immunoglobulin treatment on peripheral blood cells in children with Kawasaki disease complicated with coronary artery lesion[J].Ital J Pediatr, 2025,51(1):44.
[6] Jone PN, Tremoulet A, Choueiter N.Update on diagnosis and management of kawasaki disease: a scientific statement from the american heart association[J]. Circulation, 2024,150(23):e481-e500.
[7] Burns JC. The etiologies of Kawasaki disease[J].J Clin Invest, 2024,134(5):e176938.
[8] Wang H, Shimizu C, Bainto E, et al. Subgroups of children with Kawasaki disease: a data-driven cluster analysis[J].Lancet Child Adolesc Health, 2023,7(10):697-707.
[9] Noval RM, Kocatürk B, Franklin BS, et al. Platelets in Kawasaki disease: mediators of vascular inflammation[J].Nat Rev Rheumatol, 2024,20(8):459-472.
[10] Du Y, Lee PY. At the heart of treating kawasaki disease: the search for new approaches to prevent coronary artery aneurysms[J].Arthritis Rheumatol, 2023,75(2):149-152.
[11] Tang Y, Ding C, Xu Q, et al. Prediction nomogram for coronary artery aneurysms at one month in Kawasaki disease[J].Ital J Pediatr, 2023,49(1):146.
[12] Yang C, Yang Y, Cao S, et al. Kawasaki disease coronary artery lesions prediction with monocyte-to-high-density lipoprotein ratio[J].Pediatr Res, 2023,94(1):246-251.
[13] Day-lewis M, Son MBF, Lo MS. Kawasaki disease: contemporary perspectives[J].Lancet Child Adolesc Health, 2024,8(10):781-792.
[14] Efrati S, Averbukh M, Berman S,et al. N-Acetylcysteine ameliorates lithium-induced renal failure in rats[J].Nephrol Dial Transplant, 2005,20(1):65-70.
[15] Xie Z, Huang Y, Li X, et al. Atlas of circulating immune cells in Kawasaki disease[J].Int Immunopharmacol, 2022,102:108396.
[16] Wang S, Qian G, Liu Y, et al. Kawasaki disease: insights into the roles of T cells[J].Front Immunol, 2025,16:1582638.
[17] Shuai S, Zhang H, Zhang R, et al. Prediction of coronary artery lesions based on C-reactive protein levels in children with Kawasaki disease: a retrospective cohort study[J].J Pediatr (Rio J), 2023,99(4):406-412.
[18] Chen Y, Huang W, Hou M, et al. The predictive value of urinary albumin-to-creatinine ratio for coronary artery abnormalities in Kawasaki disease[J].Front Pediatr, 2025,13:1583603.
[19] Geng M, Zhang K. CRP-Albumin-Lymphocyte index (CALLYI) as a risk-predicting biomarker in association with osteoarthritis[J].Arthritis Res Ther, 2025,27(1):57.
[20] Pan Y, Liu Z, Tu R, et al. The value of the CRP-albumin-lymphocyte index (CALLY index) as a prognostic biomarker in acute ischemic stroke[J].Sci Rep, 2025,15(1):13672.
[21] Saridas A, Çetinkaya R. The Prognostic value of the CALLY index in sepsis: a composite biomarker reflecting inflammation, nutrition, and immunity[J].Diagnostics (Basel), 2025,15(8):1026.
[22] Luo L, Li M, Xi Y, et al. C-reactive protein-albumin-lymphocyte index as a feasible nutrition-immunity-inflammation marker of the outcome of all-cause and cardiovascular mortality in elderly[J].Clin Nutr ESPEN, 2024,63:346-353.
[23] Han D, Wu L, Zhou H, et al. Associations of the C-reactive protein-albumin-lymphocyte index with all-cause and cardiovascular mortality among individuals with cardiovascular disease: evidence from the NHANES 2001-2010[J].BMC Cardiovasc Disord, 2025,25(1):144.
[24] Demir Y, Sevinc S. The prognostic value of C-reactive protein-albumin-lymphocyte (CALLY) index in predicting in-hospital mortality after primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction (STEMI)[J].Catheter Cardiovasc Interv, 2025,106(2):1111-1118.
[25] 中华医学会儿科学分会心血管学组,中华医学会儿科学分会风湿学组, 中华医学会儿科学分会免疫学组.川崎病诊断和急性期治疗专家共识[J].中华儿科杂志,2022,60(1):6-13.
[26] Jia P, Shen F, Zhao Q, et al. Association between C-reactive protein-albumin-lymphocyte index and overall survival in patients with esophageal cancer[J].Clin Nutr, 2025, 45:212-222.
[27] Duan Y, Wang T, Jia P, et al. Association between C-reactive protein-albumin-lymphocyte (CALLY) index with intravenous immunoglobulin non-response in Kawasaki disease[J].Ann Med, 2025,57(1):2548023.
[28] Psarakis G, Farmakis I, Zafeiropoulos S, et al. Predictive role of platelet-associated indices on admission and discharge in the long-term prognosis of acute coronary syndrome patients[J].Angiology, 2022,73(5):453-460.
[29] Wu Z, Fu L, Liu X, et al. The relationship between C-reactive protein-albumin-lymphocyte index and peripheral artery disease[J].Sci Rep, 2025, 15(1):24380.
[30] Takeda Y, Sugano H, Okamoto T, et al. Prognostic usefulness of the C-reactive protein-albumin-lymphocyte (CALLY) index as a novel biomarker in patients undergoing colorectal cancer surgery[J].Asian J Surg, 2024,47(8):3492-3498.
[31] Xu Z, Tang J, Xin C, et al. Associations of C-reactive protein-albumin-lymphocyte (CALLY) index with cardiorenal syndrome: Insights from a population-based study[J].Heliyon, 2024,10(17):e37197.
[32] Ranasinghe RN, Biswas M, Vincent RP. Prealbumin: the clinical utility and analytical methodologies[J].Ann Clin Biochem, 2022,59(1):7-14.
[33] Shi M, Mao X, Wu X, et al. Serum prealbumin levels and risks of adverse clinical outcomes after ischemic stroke[J].Clin Epidemiol, 2024,16:707-716.
[34] Pardo E, Jabaudon M, Godet T, et al. Dynamic assessment of prealbumin for nutrition support effectiveness in critically ill patients[J].Clin Nutr, 2024, 43(6): 1343-1352.
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