CRP、ESR及NT-proBNP与川崎病冠状动脉损害的相关性研究  

Study on the association between CRP、ESR、NT-proBNP with coronary artery lesions in Kawasaki disease

作　　者：薛秋雨 潘筱[2] Xue Qiuyu;Pan Xiao(Clinical College of Weifang Medical University,Shandong Weifang 261000,China;The Second Ward of Linyi People’s Hospital,Shandong Linyi 276000,China)

机构地区：[1]潍坊医学院临床学院,山东潍坊261000 [2]临沂市人民医院儿内二病区,山东临沂276000

出　　处：《中国妇幼健康研究》2021年第4期504-508,共5页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨C-反应蛋白(CRP)、红细胞沉降率(ESR)及N末端脑利钠肽前体(NT-proBNP)水平与川崎病患儿合并冠状动脉损害(CAL)的相关性。方法选取2018年1月至2019年6月临沂市人民医院儿内二病区收治的84例川崎病患儿为研究对象,并根据超声心动图的检查结果评估CAL的发生情况,将其分为CAL组(17例)和无CAL组(67例),分析两组患儿的一般情况及白细胞计数、血小板计数、CRP、ESR、NT-proBNP等的差异。结果在84例川崎病患儿中,有17例发生CAL,占20.2%;67例未发生CAL,占79.8%。两组患儿的结膜充血、淋巴结肿大、杨梅舌、手足硬肿临床表现分布,以及白细胞计数、ESR水平比较差异均无统计学意义(均P>0.05)。两组患儿的皮疹发生率、发热时间及CRP和NT-proBNP水平比较差异均有统计学意义(χ^(2)=-3.982、t=-2.813、t=-2.540、Z=-4.570,均P<0.05)。多因素分析显示,高水平CRP和NT-proBNP为CAL发生的独立危险因素(CRP:OR=1.020,95%CI:1.000~1.040,P=0.047;NT-proBNP:OR=1.001,95%CI:1.000~1.001,P=0.018)。CRP、NT-proBNP的ROC曲线下面积分别为0.606、0.860;其界值分别为65.9mg/L和595.1pg/mL;敏感度分别为52.9%和100.0%;特异度分别为22.4%和68.6%。结论CRP、NT-proBNP是CAL的独立危险因素,且NT-proBNP可以更有效地预测CAL的发生。Objective To investigate the correlation between c-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels and coronary artery lesions(CAL)in children with Kawasaki disease.Methods 84 cases of children with Kawasaki disease treated in Linyi City People’s Hospital from January 2018 to June 2019 was selected as the research object.According to the inspection results of echocardiography assess the occurrence of CAL,they were divided into CAL group(17 cases)and non-CAL group(67 cases).The general conditions,white blood cell count,platelet count,CRP,ESR,and NT-proBNP of the two groups were compared and analyzed.Results Among the Kawasaki disease children,CAL occurred in 17 cases,accounting for 20.2%.CAL did not occur in 67 cases,accounting for 79.8%.There were no statistically significant differences in conjunctival congestion,lymph node enlargement,arbutus tongue,hard swelling of hands and feet,white blood cell count,and ESR level between the two groups(P>0.05).There were statistically significant differences in the incidence of rash,fever time,CRP,and NT-proBNP between the two groups(χ^(2)/t/Z=3.982,-2.813,-2.540 and-4.570,respectively,all P<0.05).Multivariate analysis showed that high levels of CRP and NT-proBNP were independent risk factors of CAL(CRP:OR=1.020,95%CI:1.000~1.040,P=0.047;NT-proBNP:OR=1.001,95%CI:1.000~1.001,P=0.018).The area under the ROC curve of CRP and NT-proBNP were 0.860 and 0.606,respectively.The cut-off values were 65.9 mg/L and 595.1 pg/ml,respectively.The sensitivities were 52.9%and 100%,respectively.The specificities were 22.4%and 68.7%,respectively.Conclusion The CRP and NT-proBNP are CAL’s independent risk factors,and NT-proBNP can more effectively predict the occurrence of CAL.

关 键 词：川崎病 冠状动脉损害 C-反应蛋白 N末端脑利钠肽前体 

分 类 号：R725.4[医药卫生—儿科]