血清8-羟基脱氧鸟苷水平对川崎病冠状动脉损伤的预测价值  

Predictive value of serum 8-hydroxydeoxyguanosine in coronary lesions of Kawasaki disease

作　　者：许海棠[1] 荣星[1] 何跃娥[1] 仇慧仙[1] 张松跃[1] 任跃[1] 褚茂平[1] 吴蓉洲[1] XU Haitang;RONG Xing;HE Yuee(Department of Cardiovascular,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第二医院儿童心血管科,325027

出　　处：《浙江医学》2018年第18期2013-2015,2019,共4页Zhejiang Medical Journal

摘　　要：目的探讨血清8-羟基脱氧鸟苷(8-OHDG)对川崎病冠状动脉损伤的预测价值。方法应用ELISA法检测60例川崎病患儿急性期及恢复期、20例发热患儿、20例健康儿童血清8-OHDG水平,并进行比较。川崎病患儿发病第2周行冠状动脉超声检查,发现冠状动脉损伤17例,冠状动脉正常43例,比较两者血清8-OHDG水平差异。采用多因素logistic回归分析川崎病患儿发生冠状动脉损伤的危险因素;绘制ROC曲线分析血清8-OHDG水平诊断川崎病冠状动脉损伤的效能;利用Pearson相关分析血清8-OHDG与C反应蛋白的相关性。结果川崎病患儿急性期血清8-OHDG水平明显高于其恢复期、发热患儿及健康儿童(均P<0.05),恢复期血清8-OHDG水平与发热患儿、健康儿童比较差异均无统计学意义(均P>0.05);发热患儿血清8-OHDG水平较健康儿童明显上升(P<0.05)。川崎病急性期冠状动脉损伤患儿血清8-OHDG水平明显高于冠状动脉正常患儿(P<0.05)。血清WBC(OR=1.472,95%CI:1.023~2.118)、C反应蛋白(OR=1.080,95%CI:1.014~1.149)、8-OHDG水平(OR=1.534,95%CI:1.016~2.717)均是川崎病患儿发生冠状动脉损伤的影响因素。其中血清8-OHDG水平诊断川崎病冠状动脉损伤的截断值为35.40pg/ml,灵敏度为0.82,特异度为0.58,AUC为0.763。川崎病患儿血清8-OHDG与C反应蛋白呈正相关(r=0.507,P<0.05)。结论血清8-OHDG水平可作为早期预测川崎病冠状动脉损伤的标志物。Objective To explore the predictive value of serum 8-hydroxydeoxyguanosine（8-OHDG） level in coronary artery injury of Kawasaki disease. Methods Serum 8-OHDG levels in 60 children with Kawasaki disease, 20 children with fever and 20 healthy children were detected by ELISA method. Based on coronary artery ultrasonography in the second week of onset,coronary artery injury were detected in 17 cases（28.3%）. The serum 8-OHDG levels in children with Kawasaki disease were compared with children with fever and healthy children. Multivariate logistic regression was used to analyze the risk factors of coronary artery lesions in children with Kawasaki disease. The ROC curve was used to assess the value of serum 8-OHDG level in predicting Kawasaki disease coronary artery injury. The correlation between serum 8-OHDG and C-reactive protein（CRP） was examined by Pearson correlation. Results The serum 8-OHDG level in children with Kawasaki disease at acute phase was significantly higher than that in the patients at recovery phase, children with fever and healthy children（P〈0.05）. There was no significant difference between patients at recovery phase and children with fever, healthy children（P〈0.05）. The serum 8-OHDG level in children with fever was significantly higher than that in healthy children（P〈0.05）. Serum 8-OHDG levels in Kawasaki disease children with acute coronary artery injury were significantly higher than those with normal coronary artery（P〈0.05）.Multivariate logistic regression analysis showed that serum WBC（OR=1.472, 95% CI：1.023-2.118）, CRP（OR=1.080, 95% CI：1.014-1.149）, 8-OHDG level（OR=1.534, 95%CI：1.016-2.717） were risk factors of coronary artery injury in children with Kawasaki disease. ROC analysis showed that the area under the curve（AUC） of serum 8-OHDG level for prediction of Kawasaki disease coronary artery injury was 0.763, taking 8-OHDG 35.40 pg/ml ad the cut-off value, the sensitivity and specificity was 0.82 and 0.58,respectively. Serum 8-OHDG w

关 键 词：8-羟基脱氧鸟苷 川崎病 冠状动脉损伤 

分 类 号：R725.4[医药卫生—儿科]