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Received:December 28, 2021 Published Online:May 20, 2022
Received:December 28, 2021 Published Online:May 20, 2022
中文摘要: 目的 探讨血清白细胞介素-6（IL-6）和N端脑钠肽前体（NT-proBNP）在预测川崎病并冠状动脉损害（CAL）中的临床价值。方法 选择2019年11月至2021年11月60例在蚌埠市第一人民医院收治并确诊为川崎病的患儿作为研究对象，根据超声心动图诊断结果分为CAL组24例和无CAL组（nCAL组）36例，同期收治30例呼吸道感染患儿作为对照组。采用两步双抗夹心酶联免疫吸附法(ELISA)检测患儿血清IL-6、NT-proBNP、C反应蛋白（CRP）、白细胞（WBC）、红细胞沉降率（ESR）、降钙素原(PCT)、白蛋白及血钠的水平，采用多因素Logistic回归分析川崎病并CAL的独立危险因素，并采用ROC曲线分析IL-6和NT-proBNP水平对川崎病并CAL的诊断效能。结果 川崎病患儿血清NT-proBNP、IL-6、CRP、WBC、ESR及PCT水平显著高于对照组，而白蛋白及血钠水平显著低于对照组（P<0.05，P<0.01）。CAL组患儿血清NT-proBNP、IL-6、CRP、WBC、ESR均显著高于nCAL组，白蛋白及血钠水平显著低于nCAL组（P<0.05，P<0.01）。多因素Logistic回归分析显示，IL-6和NT-proBNP为川崎病并CAL发生的独立影响因素（P<0.05）。IL-6、NT-proBNP的ROC曲线下面积分别为0.683、0.886；其诊断临界值分别为185.39 pg/ml和1 020.45 pg/ml；诊断敏感性分别为85.70%和90.50%，特异性分别为77.83%和88.91%。结论 血清IL-6和NT-proBNP水平的升高可作为早期预测川崎病并CAL的特异性生化指标
Abstract:ObjectiveTo investigate the clinical value of serum interleukin 6 (IL-6) and N-terminal brain natriuretic peptide precursor(NT-proBNP) in predicting Kawasaki disease(KD) with coronary artery damage(CAL) in children with KD. Methods Sixty children diagnosed with KD at the Bengbu First People's Hospital from November 2019 to November 2021 were selected as study subjects. According to the results of echocardiography, they were divided into CAL group(n=24) and non-CAL grouP(nCAL group, n=36), and 30 children with respiratory tract infection admitted at the same time were selected as control group. Serum levels of IL-6, NT-proBNP, C-reactive protein (CRP), white blood cells (WBC), erythrocyte sedimentation rate (ESR), calcitoninogen (PCT), albumin and sodium were measured by two-stePdouble antibody sandwich enzyme-linked immunosorbent assay(ELISA). Multivariate Logistic regression was used to analyze the independent risk factors of KD and CAL, and ROC curve was used to analyze the diagnostic efficacy of IL-6 and NT-proBNPlevels in KD and CAL. Results Compared with control group, serum NT-proBNP, IL-6, CRP, WBC, ESR and PCT levels were significantly higher, while albumin and blood sodium levels were significantly lower in children with KD (P<0.05, P<0.01). Compared with nCAL group, serum NT-proBNP, IL-6, CRP, WBC, ESR were significantly higher, while albumin and blood sodium levels were significantly lower in the CAL grouP(P<0.05,P<0.01). Multivariate logistic regression analysis showed that IL-6 and NT-proBNPwere independent influencing factors of KD and CAL (P<0.05). The areas under the ROC curves of IL-6 and NT-proBNPwere 0.683 and 0.886, respectively, their diagnostic critical values were 185.39 pg/ml and 1 020.45 pg/ml, respectively, the diagnostic sensitivity was 85.70% and 90.50%, and the specificity was 77.83% and 88.91%. Conclusion Elevated serum IL-6 and NT-proBNPlevels can be used as specific biochemical indicators for early prediction of KD and CAL, and NT-proBNPis more accurate in predicting the occurrence of CAL.
keywords: Kawasaki disease Interleukins N-terminal brain natriuretic peptide precursors Coronary artery lesions
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基金项目:国家自然科学基金（82070513）
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