川崎病患儿急性期血清可溶性CD40配体的表达及对冠状动脉病变的诊断价值  

Serum soluble CD40 ligand expression in children with Kawasaki disease in acute phase and its clinical significance

作　　者：孙益芳 安新江 薛莹 张弛 王镇洲 石丹 Sun Yifang;An Xinjiang;Xue Ying;Zhang Chi;Wang Zhenzhou;Dan Shi(Department of Cardiovascular Medicine,Xuzhou Children's Hospital,Xuzhou Medical University,Xuzhou 221002,China)

机构地区：[1]徐州医科大学附属徐州儿童医院心血管内科,徐州221002

出　　处：《中国综合临床》2023年第2期112-117,共6页Clinical Medicine of China

摘　　要：目的探讨川崎病患儿急性期血清可溶性CD40配体(soluble CD40 ligand, sCD40L)的表达及对冠状动脉病变(coronary artery lesion, CAL)的诊断价值。方法本研究采用病例对照研究方法。选取徐州医科大学附属徐州儿童医院2021年8月至2022年8月收治的川崎病患儿127例(川崎病组), 根据冠状动脉受累程度分为CAL组和无CAL组, 选取同期于本院进行查体的健康儿童30名为健康对照组, 另选取本院同期收治的急性上呼吸道感染发热患儿30例为发热对照组。比较有无CAL组川崎病患儿与发热对照组和健康对照组血清sCD40L水平, 不同冠状动脉扩张程度CAL患儿血清sCD40L水平, 分析川崎病患儿血清sCD40L与各实验室指标的相关性和川崎病患儿并发CAL的影响因素, 评价血清sCD40L用于川崎病并发CAL的筛查效果。呈正态分布的计量资料以xˉ±s表示, 两组间比较采用独立样本t检验;多组间比较采用单因素方差分析, 两两比较采用LSD法并做Bonferroni校正。非正态分布的计量资料以M(Q1, Q3)表示, 两组间比较采用Mann-WhitneyU检验。相关性分析采用Pearson法和Spear man法。川崎病患儿并发CAL的影响因素分析采用Logistic回归模型;绘制受试者工作特征曲线分析血清sCD40L水平对川崎病并发CAL的诊断价值。结果 127例川崎病患儿根据有无CAL分为CAL组45例和无CAL组82例, CAL组血清sCD40L水平高于无CAL组、发热对照组和健康对照组[(7.03±0.91)μg/L比(4.66±1.23)、(2.21±1.08)、(1.73±0.96)μg/L], 差异均有统计学意义(均P<0.001)。CAL组中冠状动脉扩张患儿血清sCD40L水平低于小型冠状动脉瘤、中型冠状动脉瘤和大型冠状动脉瘤患儿[(6.04±0.22)μg/L比(6.95±0.69)、(8.02±0.57)、(8.23±0.26)μg/L], 差异均有统计学意义(均P<0.001)。川崎病患儿血清sCD40L水平与血小板计数、C反应蛋白、氨基末端脑钠肽前体、白细胞介素6、白细胞介素8、肿瘤坏死因子α均呈正�Objective To investigate the expression of soluble CD40 ligand(sCD40L)in serum of children with Kawasaki disease at acute stage and its diagnostic value in coronary artery disease(CAL).Methods This study adopts case-control study method.Select 127 children with Kawasaki disease admitted to Xuzhou Children's Hospital affiliated to Xuzhou Medical University from August 2021 to August 2022.They are divided into CAL group and non-CAL group according to the degree of coronary artery involvement.Select 30 healthy children who have physical examination in this hospital at the same time as the healthy control group,and select another 30 children with acute upper respiratory tract infection and fever admitted to this hospital at the same time as the fever control group.Compare the sex,age and laboratory indicators of children with Kawasaki disease with or without CAL,and compare the difference between the serum sCD40L level of children with Kawasaki disease with or without CAL and the fever control group and the healthy control group,the serum sCD40L level of children with different degrees of coronary artery dilation,and analyze the correlation between the serum sCD40L and various laboratory indicators of children with Kawasaki disease and the influencing factors of children with Kawasaki disease complicated with CAL,To evaluate the screening effect of serum sCD40L for Kawasaki disease complicated with CAL.The measurement data with normal distribution is expressed by x¯±s,the comparison between the two groups adopts independent sample t-test,the comparison between multiple groups adopts one-way ANOVA,and the comparison between two groups adopts LSD method and Bonferroni correction;The measurement data of non-normal distribution is expressed by M(Q1,Q3),and the comparison between the two groups is conducted by Mann-Whitney U test.Pearson method and Spearman mothod were used for correlation analysis.Logistic regression model was used to analyze the influencing factors of children with Kawasaki disease complicated with CA

关 键 词：川崎病 冠状动脉病变 可溶性CD40配体 儿童 

分 类 号：R725.4[医药卫生—儿科]