川崎病急性期NT-pro BNP、PLR的临床意义  

Role of NT-proBNP and PLR in the Acute Phase of Kawasaki Disease

作　　者：王琼琼 郑丽云[1] 赵胜[1] WANG Qiong-qiong;ZHENG Li-yun;ZHAO Sheng(Department of Cardiology,Provincial Children’s Hospital,Anhui Medical University,Hefei 230051,Anhui,China)

机构地区：[1]安徽医科大学附属省儿童医院心内科,合肥市230051

出　　处：《中国分子心脏病学杂志》2021年第6期4273-4277,共5页Molecular Cardiology of China

基　　金：安徽医科大学临床科学基金项目(2019xkj079)。

摘　　要：目的探讨N末端脑利纳肽原(NT-proBNP)、血小板/淋巴细胞比值(PLR)在川崎病急性期的临床意义。方法选取安徽医科大学附属省儿童医院2019年8月至2021年5月住院的114例急性期川崎病患儿作为研究对象,另选取同期年龄相匹配的30例发热患儿(发热对照组)及30例健康体检儿童(健康对照组);观察NT-proBNP、PLR水平的变化。结果川崎病组NT-proBNP和PLR水平[303.1(111.6,841.9)pg/ml;108.7(78.9,177.5)]高于发热对照组[39.8(17.8,47.3)pg/ml;85.9(70.7,123.2)]及健康对照组[25.6(14.6,37.3)pg/ml;74.6(61.8,99.5)](P<0.05);NT-proBNP水平有二尖瓣反流者[450(182,1069)pg/ml]高于无二尖瓣反流者[184(92,652)pg/ml](P<0.05),有冠状动脉损伤者[443(160,1309)pg/ml]高于无冠状动脉损伤者[182(66,547)pg/ml](P<0.05);肝损伤者PLR[163(98,227)]高于无肝损伤者[103(73,151)](P<0.05);NT-proBNP与C反应蛋白(r=0.37,P<0.01)及左心室舒张末期内径(r=0.22,P<0.05)正相关,与血红蛋白(r=-0.23,P<0.05)及白蛋白(r=-0.25,P<0.01)负相关;PLR与左心室舒张末期内径(r=0.24,P<0.05)、左心室收缩末期内径(r=0.27,P<0.01)正相关,与白细胞计数(r=-0.27,P<0.01)负相关。NT-proBNP和PLR诊断川崎病的受试者操作特征曲线下面积(AUC)分别为0.908(95%CI:0.864~0.953,P<0.01)和0.675(95%CI:0.596~0.754,P<0.01),两者联合后AUC为0.938(95%CI:0.902~0.974,P<0.01)。NT-proBNP预测冠状动脉损伤的AUC为0.653(95%CI:0.552~0.753,P<0.01)。结论NT-proBNP和PLR有助于川崎病诊断,NT-proBNP可预测冠状动脉损伤。Objective To explore the clinical meaning of N-terminal pro brain natriuretic peptide(NT-proBNP)and platelet-to-lymphocyte ratio(PLR)in the acute phase of Kawasaki disease(KD)in children.Methods 114 children in the acute phrase of KD in Provincial Children’s Hospital Affiliated to Anhui Medical University from August 2019 to May 2021 were assigned to KD group,while the other 30 children with fever not caused by KD and 30 healthy children were selected as control groups and their age were similar to KD group’s.Levels of NT-proBNP and PLR were measured in all those mentioned children and their difference was observed in different groups and different clinical manifestations.Results Levels of NT-proBNP and PLR[303.1(111.6,841.9)pg/ml and 108.7(78.9,177.5)]in KD group were higher than that of fever group[39.8(17.8,47.3)pg/ml and 85.9(70.7,123.2)]and healthy group[25.6(14.6,37.3)pg/ml and 74.6(61.8,99.5)](P<0.05).The NT-proBNP level was significantly higher in patients with mitral regurgitation(MR)[450(182,1069)pg/ml]than that in without MR[184(92,652)pg/ml](P<0.05),and higher in patients with coronary artery lesion(CAL)[443(160,1309)pg/ml]than that in without CAL(NCAL)[182(66,547)pg/ml](P<0.05).The PLR level was significantly higher in patients with liver injury[163(98,227)]than without liver injury[103(73,151)](P<0.05).The NT-proBNP level was positively correlated with CRP(r=0.37,P<0.01)and left ventricular diastasis diameter(LVDD)(r=0.22,P<0.05),while negatively correlated with Hb(r=–0.23,P<0.05)and albumin levels(r=–0.25,P<0.01).The PLR level was positively correlated with LVDD(r=0.24,P<0.05)and left ventricular internal dimension systole(LVDS)(r=0.27,P<0.01),but negatively correlated with the WBC(r=–0.27,P<0.01).Area under the receiver operating curve of NT-proBNP and PLR in diagnosis of KD were 0.908(95%CI:0.864-0.953,P<0.01)and 0.675(95%CI:0.596-0.754,P<0.01)respectively,while the area under the ROC curve of NT-proBNP combined with PLR in diagnosis of KD was 0.938(95%CI:0.902-0.974,P<0.01).The area un

关 键 词：N末端脑利钠肽原 血小板与淋巴细胞比值 冠状动脉损伤 川崎病 

分 类 号：R725.4[医药卫生—儿科]