川崎病CK-MB、NT-proBNP、H-FABP和冠状动脉Z值的变化及其与冠脉病变的相关性研究  

Changes of CK-MB, NT-proBNP, H-FABP and coronary Z value in Kawasaki disease and their correlation with coronary artery disease

作　　者：孙欣娜 于泊[2] 杨青[1] 成佳文 胡正权[1] 杨茜芸 张世娜 SUN Xin-na;YU Bo;YANG Qing(Department of Pediatrics,the Seventh People's Hospital of Hebei Province(the Second Affiliated Hospital of Hebei College of Traditional Chinese Medicine),Baoding Hebei 073000,China;Department of Operating Room,Affiliated Hospital of Hebei University,Baoding Hebei 071000,China)

机构地区：[1]河北省第七人民医院(河北中医学院第二附属医院)儿科,河北保定073000 [2]河北大学附属医院手术室,河北保定071000

出　　处：《临床和实验医学杂志》2022年第13期1384-1387,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省科技计划项目(编号:19020B621)。

摘　　要：目的探讨川崎病肌酸激酶同工酶(CK-MB)、N末端脑钠尿肽前体(NT-proBNP)、心型脂肪酸结合蛋白(H-FABP)和冠状动脉Z值的变化及其与冠脉病变的相关性。方法回顾性选取2015年2月至2019年6月河北省第七人民医院收治的川崎病患儿80例作为研究对象,其中急性期37例,恢复期43例;根据是否发生冠状动脉病变(CAL)分为CAL组29例与无CAL组51例。另选择2015年2月至2019年6月健康体检儿童40名作为对照组。采用免疫化学法测定血清CK-MB水平;采用化学发光免疫分析法测定血清NT-proBNP水平;采用免疫比浊法测定血清H-FABP水平;测量左冠状动脉主干(LCA)宽度和右冠状动脉主干(RCA)宽度,计算Z值。结果急性期组血清CK-MB、NT-proBNP和H-FABP水平高于恢复期组,急性期组和恢复期组血清CK-MB、NT-proBNP和H-FABP水平高于对照组,差异均有统计学意义(P<0.05)。急性期组LCA-Z值和RCA-Z值高于恢复期组,急性期组和恢复期组LCA-Z值和RCA-Z值高于对照组,差异均有统计学意义(P<0.05)。经ROC曲线分析,川崎病诊断中,CK-MB敏感度86.5%、特异度93.0%,NT-proBNP敏感度89.2%、特异度93.0%,H-FABP敏感度62.2%、特异度90.7%。CAL组血清CK-MB、NT-proBNP和H-FABP水平高于无CAL组,差异均有统计学意义(P<0.05)。CAL组LCA-Z值和RCA-Z值高于无CAL组,差异均有统计学意义(P<0.05)。CK-MB、NT-proBNP、H-FABP、LCA-Z值和RCA-Z值与CAL呈线性正相关(P<0.05)。结论川崎病患儿CK-MB、NT-proBNP、H-FABP和冠状动脉Z值与冠脉病变呈明显相关性,且与患儿病情程度密切相关。Objective To investigate the relationship between Kawasaki disease creatine kinase isoenzyme(CK-MB),N-terminal pro-brain natriuretic peptide(NT-proBNP),heart-type fatty acid-binding protein(H-FABP)and coronary Z value.Changes and their association with coronary artery disease.Methods A total of 80 children with Kawasaki disease in the Seventh People's Hospital of Hebei Province from February 2015 to June 2019 were selected as the research subjects,including 37 cases in the acute stage and 43 cases in the recovery stage;according to the occurrence of coronary artery disease(CAL),they were divided into CAL group(29 cases)and non-CAL group(51 cases).Another 40 healthy children from February 2015 to June 2019 were selected as the control group.Serum CK-MB levels were determined by immunochemical assay;serum NT-proBNP levels were determined by chemiluminescence immunoassay;serum H-FABP levels were determined by immunoturbidimetry;left main coronary artery(LCA)width and right main coronary artery were measured(RCA)width,calculated Z value.Results The acute stage group serum CK-MB,NT-proBNP and H-FABP were higher recovery stage group,the differences were statistically significant(P<0.05);the acute stage group and recovery stage group serum CK-MB,NT-proBNP and H-FABP levels were higher control group,the differences were statistically significant(P<0.05).The acute group LCA-Z and RCA-Z values were higher recovery group,the acute and recovery groups LCA-Z and RCA-Z values were higher control group,the differences were statistically significant(P<0.05).According to ROC curve analysis,in the diagnosis of Kawasaki disease,CK-MB has a sensitivity of 86.5%and a specificity of 93.0%,NT-proBNP has a sensitivity of 89.2%and a specificity of 93.0%,and H-FABP has a sensitivity of 62.2%and a specificity of 90.7%.The serum levels of CK-MB,NT-proBNP and H-FABP in the CAL group were higher than those in the non-CAL group,the differences were statistically significant(P<0.05).The LCA-Z and RCA-Z values in the CAL group were higher than t

关 键 词：冠脉病变 Z值 心型脂肪酸结合蛋白 N末端脑钠尿肽前体 肌酸激酶同工酶 川崎病 

分 类 号：R725.4[医药卫生—儿科]