脂源性细胞因子Omentin-1、Chemerin对川崎病患儿冠状动脉损伤的预测价值  

Predictive Value of Lipid-derived Cytokines Omentin-1 and Chemerin in Coronary Artery Injury in Children with Kawasaki Disease

作　　者：董焱[1] 宋靖荣[1] DONG Yan;SONG Jingrong(Department of Pediatrics,Shanghai Ninth People′s Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 201900,China)

机构地区：[1]上海交通大学医学院附属第九人民医院儿科,上海201900

出　　处：《医学综述》2020年第21期4349-4353,共5页Medical Recapitulate

摘　　要：目的分析脂源性细胞因子血浆网膜素-1(Omentin-1)、趋化素(Chemerin)对川崎病患儿冠状动脉损伤的预测价值。方法选择2014年1月至2019年12月上海交通大学医学院附属第九人民医院收治的109例川崎病患儿为研究对象,根据是否合并冠状动脉损伤分为冠状动脉损伤组(25例)和非冠状动脉损伤组(84例),选择同期行健康体检的20名儿童作为健康对照组。比较各组的一般资料,采用多因素Logistic回归分析冠状动脉损伤的独立危险因素,采用受试者工作特征曲线(ROC曲线)分析脂源性细胞因子Omentin-1、Chemerin在冠状动脉损伤中的预测价值。结果冠状动脉损伤组、非冠状动脉损伤组患儿白细胞计数、血小板计数、中性粒细胞百分比及Omentin-1、Chemerin水平均明显高于健康对照组[(16.24±2.31)×10^9/L、(15.76±2.40)×10^9/L比(8.57±1.26)×10^9/L,(384.5±87.3)×10^9/L、(369.8±91.4)×10^9/L比(287.2±48.8)×10^9/L,(0.87±0.11)、(0.84±0.10)比(0.55±0.08),(35.72±5.47)μg/L、(34.54±5.21)μg/L比(24.63±3.13)μg/L,(367.1±54.8)μg/L、(274.6±48.9)μg/L比(204.6±34.5)μg/L],且冠状动脉损伤组患儿Chemerin水平明显高于非冠状动脉损伤组[(367.1±54.8)μg/L比(274.6±48.9)μg/L](P <0.05)。多因素Logistic回归分析结果显示,脂源性细胞因子Chemerin是川崎病患儿冠状动脉损伤的独立危险因素(P <0.05)。脂源性细胞因子Omentin-1预测冠状动脉损伤的ROC曲线下面积(AUC)为0.624(95%CI 0.494~0.755),当临界值为28.4μg/L时,灵敏度为63.3%,特异度为58.5%;脂源性细胞因子Chemerin预测冠状动脉损伤的AUC为0.839(95%CI 0.748~0.930),当临界值为264.9μg/L时,灵敏度为91.8%,特异度为83.7%。结论脂源性细胞因子Chemerin可作为川崎病及其冠状动脉损伤的预测因子,对早期鉴别诊断以及冠状动脉损伤的治疗具有重要意义;而脂源性细胞因子Omentin-1在合并冠状动脉损伤的川崎病患儿中表达水平与非冠状动脉损伤患Objective To investigate the predictive value of plasma omentin-1 and chemerin on coronary artery injury in children with Kawasaki disease.Methods A total of 109 cases of children with Kawasaki disease in Shanghai Ninth People’s,Shanghai Jiaotong University School of Medicine between Jan.2014 and Dec.2019 were included in the study.According to whether combined with coronary artery lesions they were divided into a coronary artery injury group of 25 cases a non-coronary artery injury group of 84 cases,while another 20 healthy children for health checkup during the same period were included as a healthy control group.The general information of each group was compared,and multivariate Logistic regression analysis was adopted for analysis of independent risk factors of coronary artery lesion,and receiver operating characteristic curve(ROC) was used for the analysis of lipid-derived cytokines Omentin-1,Chemerin for their predictive value for coronary artery lesions.Results The levels of white blood cell count,platelet count,neutrophil,omentin-1 and chemerin in the coronary artery injury group and non-coronary artery injury group were significantly higher than those in the healthy control group16.24±2.31)×10^9/L,(15.76±2.40)×10^9/L vs (8.57±1.26)×10^9/L;(384.5±87.3)×10^9/L,(369.8±91.4)×10^9/L vs (287.2±48.8)×10^9/L;(0.87±0.11),(0.84±0.10) vs (0.55±0.08);(35.72±5.47)μg/L,(34.54±5.21)μg/L vs (24.63±3.13)μg/L;(367.1±54.8)μg/L,(274.6±48.9)μg/L vs (204.6±34.5)μg/L],and the level of chemerin in the coronary artery injury group was significantly higher than that in the noncoronary artery injury group[(367.1±54.8)μg/L vs (274.6±48.9)μg/L](P<0.05).Multivariate Logistic regression analysis showed that lipid-derived cytokine chemerin was an independent risk factor for coronary artery injury in children with Kawasaki disease(P<0.05).The area under the ROC area under curve(AUC) of omentin-1 in predicting coronary artery injury was 0.624(95%CI 0.494-0.755),and when the critical value was 28.4μg/L,th

关 键 词：川崎病 冠状动脉损伤 脂源性细胞因子 血浆网膜素-1 趋化素 危险因素 预测价值 

分 类 号：R725.8[医药卫生—儿科]