血清IMA、Lp-PLA2对川崎病患儿冠状动脉损伤的诊断价值  

Diagnostic value of serum IMA and Lp-PLA2 for coronary artery injury in children with Kawasaki disease

作　　者：陈棉[1] 方声[1] 王敏娜[1] 朱海燕[1] CHEN Mian;FANG Sheng;WANG Min-Na(Taizhou Hospital of Zhejiang Province,Taizhou,Zhejiang 317000,China)

机构地区：[1]浙江省台州医院

出　　处：《中国妇幼保健》2019年第21期4948-4951,共4页Maternal and Child Health Care of China

基　　金：浙江省自然科学基金资助项目(LY16H160149)

摘　　要：目的分析川崎病(KD)伴冠状动脉损伤患儿血清缺血修饰白蛋白(IMA)和脂蛋白相关磷脂酶A2(Lp-PLA2)表达水平及其对KD伴冠状动脉损伤的早期诊断价值。方法将2017年1月-2018年6月收治的96例KD患儿(KD组)根据超声检查结果分为冠状动脉损伤组51例和无损伤组45例,选择同时期50例体检健康儿童为健康组,分别检测受试者血清白细胞(WBC)、白蛋白(ALB)、C反应蛋白(CRP)及IMA、Lp-PLA2水平,采用受试者工作特征曲线(ROC)评估血清IMA、Lp-PLA2水平对KD伴冠状动脉损伤的诊断价值,多因素Logistic回归模型分析KD并发冠脉损伤的危险因素。结果KD组与健康组血清WBC、ALB、CRP、IMA和Lp-PLA2水平比较差异均有统计学意义(均P<0.05)。冠脉损伤组和无损伤组血清IMA和Lp-PLA2水平比较差异均有统计学意义(均P<0.05)。血清IMA诊断KD冠脉损伤的曲线下面积(AUC)为0.708,诊断临界值为73.91 U/ml;血清Lp-PLA2诊断KD冠脉损伤的AUC为0.766,诊断临界值为126.93 ng/ml。多因素Logistic回归分析显示:血清ALB、IMA和Lp-PLA2水平是KD患儿并发冠脉损伤的危险因素。结论IMA和Lp-PLA2在KD患儿血清中高表达,是冠状动脉损伤的独立危险因素,可用于早期诊断KD伴冠状动脉损伤,对提高临床疗效,改善患儿预后具有指导意义。Objective To analyze the expression levels of serum ischemia modified albumin(IMA)and lipoprotein-associated phospholipase A2(Lp-PLA2)in children with Kawasaki disease(KD)complicated with coronary artery injury and the early diagnostic value of serum IMA and Lp-PLA2 for coronary artery injury in KD children.Methods From January 2017 to June 2018,96 children with KD were divided into coronary artery injury group(51 children)and non-coronary artery injury group(45 children)according to the results of ultrasonography,50 healthy children during the same period were selected as health group.The levels of serum white blood cell(WBC),albumin(ALB),C-reactive protein(CRP),IMA,and Lp-PLA2 were detected,the value of serum IMA and Lp-PLA2 levels in diagnosis of KD complicated with coronary artery injury were evaluated by receiver operating characteristic curve(ROC),multivariate Logistic regression analysis was used to analyze the risk factors of KD complicated with coronary artery injury.Results There were statistically significant differences in the levels of serum WBC,ALB,CRP,IMA,and Lp-PLA2 between KD group and health group(P<0.05).There were statistically significant differences in the levels of serum IMA and Lp-PLA2 between coronary artery injury group and non-coronary artery injury group(P<0.05).The area under the curve(AUC)and critical value of serum IMA in diagnosis of KD complicated with coronary artery injury were 0.708 and 73.91 U/ml,respectively;AUC and critical value of serum Lp-PLA2 in diagnosis of KD complicated with coronary artery injury were 0.766 and 126.93 ng/ml.Multivariate Logistic regression analysis showed that serum levels of ALB,IMA,and Lp-PLA2 were risk factors for KD complicated with coronary artery injury in children.Conclusion The expression levels of serum IMA and Lp-PLA2 in KD children are high,IMA and Lp-PLA2 are independent risk factors for coronary artery injury,which can be used for early diagnosis of KD complicated with coronary artery injury,the two indicators have guiding significance i

关 键 词：川崎病 冠状动脉损伤 缺血修饰白蛋白 脂蛋白相关磷脂酶A2 诊断 

分 类 号：R54[医药卫生—心血管疾病]