川崎病冠状动脉损伤患儿血清可溶性人基质裂解素2的浓度及临床意义  

Serum concentration of soluble suppression of tumorigenicity 2 and its clinical significance in children with Kawasaki disease and coronary artery lesion

作　　者：李星云[1] 江德勤[1] 周宏[1] LI Xing-yun;JIANG De-qin;ZHOU Hong(Department of Pediatrics,The Fourth People′s Hospital of Zigong City,Zigong,Sichuang 643000,China)

机构地区：[1]自贡市第四人民医院儿科,四川643000

出　　处：《岭南心血管病杂志》2022年第3期205-208,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨川崎病(Kawasaki disease,KD)冠状动脉损伤(coronary artery lesion,CAL)患儿血清可溶性人基质裂解素2(soluble suppression of tumorigenicity-2,ST2)的浓度及临床意义。方法回顾性分析自贡市第四人民医院2018年10月至2019年12月的155例川崎病患儿的临床资料,分为CAL组(n=56)和无CAL组(n=99);另选取健康儿童30名为对照组。比较3组研究对象血清sST2浓度及常规实验指标如C反应蛋白(C-reactive protein,CRP)浓度、白细胞(white blood cell,WBC)计数、红细胞沉降率(erythrocyte sedimentation rate,ESR)、白蛋白浓度、血小板计数等资料的差异。结果与对照组比较,NCA组和CAL组患者血清sST2、CRP浓度及WBC计数、ESR均显著增高,而血清白蛋白浓度、血小板计数均显著降低,差异有统计学意义(P<0.05);非CAL组与CAL组患儿上述指标比较,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示sST2、CRP均为KD合并CAL的独立危险因素(P<0.05)。Pearson相关分析结果发现,sST2与CRP呈正相关(r=0.864,P=0.026)。冠状动脉扩张亚组、小中型冠状动脉瘤亚组及巨大冠状动脉瘤亚组患儿血清sST2、冠状动脉内径比较,差异有统计学意义(P<0.05)。血清sST2诊断KD合并CAL的曲线下面积为0.843,诊断临界值为73.57μg/L;sST2与CRP(曲线下面积为0.706)诊断KD合并CAL的曲线下面积比较,差异有统计学意义(P<0.05)。结论血清sST2与KD患儿CAL程度密切相关,对CAL早期诊断具有较高的预测价值。Objectives To investigate the serum concentration of soluble suppression of tumorigenicity-2(sST2)and its clinical significance in children with coronary artery lesion(CAL)due to Kawasaki disease(KD).Methods Clinical data of 155 children with KD in The Fourth People′s Hospital of Zigong City from October 2018 to December 2019 were retrospectively analyzed.They were divided into CAL group(n=56)and non-CAL group(n=99).Another 30 healthy children were selected as control group.The differences of serum concentration of sST2 and routine experimental indica⁃tors[C-reactive protein(CRP),white blood cell(WBC)count,erythrocyte sedimentation rate(ESR),albumin,platelet count]were compared among the three groups.Results Compared with control group,serum concentrations of sST2,CRP amd WBC count,ESR of non-CAL group and CAL group significantly increased,while serum concentration of albumin and platelet count significantly decreased(P<0.05).There were significant differences in the above indica⁃tors between non-CAL group and CAL group(P<0.05).Logistic regression analysis showed that sST2 and CRP were independent risk factors for KD with CAL(P<0.05).Pearson analysis found that sST2 positively correlated with CRP(r=0.864,P=0.026).There were significant differences in serum concentration of sST2 and coronary diameter among children with coronary artery dilatation,small and medium coronary aneurysms,and giant coronary aneurysms(P<0.05).The area under the curve(AUC)of serum concentration of sST2 in the diagnosis of KD combined with CAL was 0.843,and the diagnostic cut-off value was 73.57μg/L.The difference of AUC between sST2 and CRP(AUC:0.706)in the diagnosis of KD combined with CAL was statistically significant(P<0.05).Conclusions Serum sST2 closely relates to the degree of CAL in children with KD,and has a high predictive value for the early diagnosis of CAL.

关 键 词：冠状动脉损伤 可溶性人基质裂解素2 川崎病 炎症反应 

分 类 号：R541.4[医药卫生—心血管疾病]