PBN、CRP、sCD40L、G⁃CSF在IVIG无反应川崎病中表达及意义  

Expression and significance of PBN,CRP,sCD40L and G⁃CSF in IVIG⁃unresponsive Kawasaki disease

作　　者：牛冬春 吴屾 宋玉营 NIU Dongchun;WU Shen;SONG Yuying(Department of Pediatrics,staff hospital of Henan Hongyang Industry Co.,Ltd.,Nanyang,Henan,China,474678;Laboratory Department of staff hospital of Henan Hongyang Industry Co.,Ltd.,Nanyang,Henan,China,474678)

机构地区：[1]河南红阳工业有限责任公司职工医院儿科,河南南阳474678 [2]河南红阳工业有限责任公司职工医院检验科,河南南阳474678

出　　处：《分子诊断与治疗杂志》2022年第4期618-622,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(201504011)。

摘　　要：目的分析无反应性川崎病(KD)患儿外周血中性粒细胞计数(PBN)、C反应蛋白(CRP)、可溶性CD40配体(sCD40L)、粒细胞集落刺激因子(G-CSF)水平变化及对并发冠状动脉病变(CAL)的预测价值。方法选取2016年5月至2021年5月河南红阳工业有限责任公司职工医院KD患儿118例,根据IVIG治疗反应性分为IVIG无反应组(n=22)与IVIG敏感组(n=96),另选取同期60例健康儿童为健康对照组,比较3组外周血PBN、CRP、sCD40L、G-CSF水平,根据有无并发CAL将IVIG无反应组分为并发CAL患儿、无CAL患儿,比较两组外周血PBN、CRP、sCD40L、G-CSF水平,评价上述外周血各指标对IVIG无反应KD并发CAL的预测价值。结果外周血PBN、CRP、sCD40L、G-CSF水平比较:IVIG无反应组>IVIG敏感组>健康对照组,差异有统计学意义(P<0.05);VIG无反应组CAL发生率高于IVIG敏感组,差异有统计学意义(χ^(2)=8.005,P=0.005);IVIG无反应组并发CAL患儿外周血PBN、CRP、sCD40L、G-CSF水平高于无CAL患儿,差异有统计学意义(P<0.05);外周血PBN、CRP、sCD40L、G-CSF联合的AUC为0.968,优于单一诊断(P<0.05)。结论IVIG无反应KD患儿外周血PBN、CRP、sCD40L、G-CSF水平过度高表达,联合检测上述指标水平可为临床评估IVIG治疗效果、预测并发CAL提供参考依据。Objective To analyze the changes in the levels of peripheral blood neutrophil count(PBN),C-reactive protein(CRP),soluble CD40 ligand(sCD40L),and granulocyte colony stimulating factor(G-CSF)in children with intravenous immunoglobulin(IVIG)anergy Kawasaki disease(KD)and its predictive value for complicated coronary artery lesions(CAL). Methods A total of 118 children with KD in staff hospital of Henan Hongyang Industry Co.,Ltd. from May 2016 to May 2021 were selected and divided into IVIG anergy group(n=22)and IVIG sensitive group(n=96)according to the IVIG treatment response. In addition,242 healthy children during the same period were selected as healthy control group. The levels of PBN,CRP,sCD40L,and G-CSF in the peripheral blood of the three groups were compared. According to the presence or absence of CAL,the anergy components of IVIG were divided into children with CAL and children without CAL. The baseline data,peripheral blood PBN,CRP,sCD40L,and G-CSF levels were compared. The predictive value of the above-mentioned peripheral blood indicators on IVIG anergy KD complicated by CAL was evaluated. Results Comparison of the levels of PBN,CRP,sCD40 L and G-CSF in peripheral blood:IVIG anergy group>IVIG sensitive group>healthy control group(P<0.05). The incidence of CAL in the IVIG anergy group was higher than in the IVIG sensitive group(χ^(2)=8.005,P=0.005). The levels of PBN,CRP,sCD40 L,and G-CSF in the peripheral blood of children with CAL in the IVIG anergy group were higher than those of children without CAL(P<0.05). The AUC of peripheral blood PBN,CRP,sCD40 L and G-CSF in the combined prediction of IVIG anergy KD children with CAL was the largest,which was 0.968(P<0.05). Conclusion The levels of PBN,CRP,sCD40 L,and G-CSF in the peripheral blood of children with IVIG anergy KD are overexpressed. The combined detection of the above index levels can provide a reference for clinical evaluation of IVIG treatment effects and prediction of concurrent CAL.

关 键 词：川崎病 中性粒细胞计数 C反应蛋白 可溶性CD40配体 粒细胞集落刺激因子 冠状动脉病变 

分 类 号：R725.4[医药卫生—儿科]