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- Material Type
- 文書・図像類
- Author/Editor
- 野村, 裕一
- Author Heading
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- Alternative Title
- New evaluation for severity of Kawasaki disease using HMGB1 values
- Text Language Code
- jpn
- Target Audience
- 一般
- Note (General)
- 2008-2010年度科学研究費補助金(基盤研究(C))研究成果報告書 課題番号：20591281 研究代表者：野村裕一 (鹿児島大学大学院医歯学総合研究科准教授)High Mobility Group Box 1 (HMGB1)値を用いて川崎病(KD)の重症度評価として免疫グロブリン大量療法 (IVIG)不応例スクリーニングの検討を行った。【方法】KD患児のIVIG前の血清を用いてHMGB1値を初回IVIGで軽快した143例 (反応例)と追加治療を必要とした23例（不応例）を比較検討した。【結果】不応例のHMGB1値は有意に高値だった。ROC解析から得られたHMGB1値のカットオフ値(16 ng/ml)以上を予測不応例とすると、鋭敏度43%、精度73%だった。Gunmaスコア5点以上あるいはHMGB1高値を予測不応例とすると鋭敏度74%、精度63%と感度向上が得られた。【結論】川崎病の重症度評価としてのIVIG治療不応例スクリーニングにはGunmaスコアとHMGB1高値による評価が有用である。We examined the efficacy of high mobility group box 1 (HMGB1) value for evaluating the severity of KD. Methods: Serum HMGB1 values were compared between the responders (143 patients) to initial intravenous immunoglobulin (IVIG) and nonresponders (23 patients). Results: Compared with responders, non-responders showed significantly elevated HMGB1 values. ROC analysis revealed an optimal cut-off value for HMGB1 for nonresponders. The sensitivity with high HMGB1 was 43% and accuracy 73%. When predicted non-responder is defined as a patient with Gunma score of 5 or over or high HMGB1 value, the sensitivity was 74% and accuracy 63%. Conclusion: Combinational use of HMGB1 value and Gunma score is useful for determine the severity of KD as the prediction for nonresponder of IVIG.