川崎病急性期血清胱抑素C水平与冠脉病变的关系  

Association between cystatin C and coronary artery lesions in acute stage of Kawasaki disease

作　　者：吴凡 汤卫红 叶姗 潘炜 WU Fan;TANG Weihong;YE Shan;PAN Wei(Department of Internal Medicine,Hangzhou Children's Hospital,Zhejiang Hangzhou 310014,China)

机构地区：[1]杭州市儿童医院内三科,浙江杭州310014

出　　处：《中国妇幼健康研究》2020年第6期717-721,共5页Chinese Journal of Woman and Child Health Research

摘　　要：目的研究川崎病(KD)急性期血清胱抑素C(CysC)水平与冠状动脉病变(CAL)的关系,探讨血清CysC水平对川崎病急性期合并CAL的预测价值。方法回顾性分析2017年1月至2019年6月在杭州市儿童医院住院治疗的川崎病患儿235例。依据发病10天内,应用静脉注射丙种球蛋白(IVIG)及阿司匹林前超声心动图评估是否发生CAL,分为CAL组(114例)、无CAL组(121例),比较并分析两组患儿一般情况及CysC水平、白细胞计数、血小板计数、C-反应蛋白(CRP)、红细胞沉降率(ESR)等指标的差异。结果 CAL组CysC水平高于无CAL组[1.10(0.80~1.70) vs.0.70(0.50~0.80),Z=-11.035,P<0.05]。男性(OR=3.835,95%CI:1.906~7.720)、CysC(OR=192.536,95%CI:36.711~1 009.790)、血小板计数(OR=1.005,95%CI:1.002~1.007)是川崎病急性期合并CAL的独立危险因素(均P<0.05)。CysC预测川崎病急性期并发CAL的ROC曲线下面积为0.861(95%CI:0.818~0.904),其界值为0.95mg/L时,敏感度为64.6%,特异度为93.4%。结论 CysC与川崎病急性期是否合并CAL有相关性,其对川崎病患儿的病情预后有一定的预测价值。Objective To evaluate the association between cystatin C(CysC)and coronary artery lesions(CAL)in acute stage of Kawasaki disease(KD),and to evaluate the prediction value of CAL in acute stage of KD.Methods A retrospective analysis was conducted on 235patients with Kawasaki disease and admitted to Hangzhou Children's Hospital from January 2017to July 2019.All of them were divided into CAL group(with coronary artery lesion,114cases)and n-CAL group(without coronary artery lesion,121 cases)according to the assessment results of ultrasonic cardiogram within ten days of onset and before the application of intravenous immunoglobulin(IVIG)and aspirin.The following indexes were compared between the two groups,including general condition,CysC level,leukocyte count,blood platelet count(PLT),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR).Results The level of CysC in the CAL group was significantly higher than that in the n-CAL group[1.10(0.80-1.70)vs.0.70(0.50-0.80),Z=-11.035,P<0.05].Male(OR=3.835,95%CI:1.906-7.720),CysC level(OR=192.536,95%CI:36.711-1009.790)and PLT(OR=1.005,95%CI:1.002-1.007)are independent risk factors for CAL in acute stage of KD(all P<0.05).The area under the receiver operating characteristic(ROC)curve was 0.861(95%CI:0.818-0.904),and the cut-off value predicting the CAL by the CysC was 0.95mg/L,with sensitivity of 64.6%,and specificity of 93.4%.Conclusion Cystatin C concentration is closely associated with the coronary artery lesions of Kawasaki disease in acute stage,which can predict the prognosis of patients with KD.

关 键 词：川崎病 冠脉病变 胱抑素C 预后 

分 类 号：R725.5[医药卫生—儿科]