血清25-羟维生素D3、趋化因子对川崎病患儿冠状动脉损害发生的影响及预测价值  

Influence and predictive value of serum 25-hydroxyvitamin D3 and chemokine on the occurrence of coronary artery lesion in children with Kawasaki disease

作　　者：李娜娜 王红群[1] LI Nana;WANG Hongqun(Department of Pediatrics,the Second People’s Hospital of Wuhu City,Anhui Province,Wuhu241000,China)

机构地区：[1]安徽省芜湖市第二人民医院儿科,安徽芜湖241000

出　　处：《中国医药导报》2023年第19期104-107,共4页China Medical Herald

基　　金：安徽省自然科学基金面上项目(1808085MH262)。

摘　　要：目的分析血清25-羟维生素D3[25(OH)D3]、趋化因子对川崎病(KD)患儿冠状动脉损害(CAL)发生的影响及预后预测价值。方法选取2018年7月至2022年11月安徽省芜湖市第二人民医院收治的KD患儿86例为研究对象。治疗2周后,根据CAL的发生情况将其分为发生组(21例)和未发生组(65例)。比较两组临床资料及血清25(OH)D3、脂源性细胞因子水平,分析KD患儿发生CAL的影响因素,并进一步分析血清25(OH)D3、脂源性细胞因子联合检测对KD患儿CAL发生的预测价值。结果发生组KD急性期占比、静脉注射免疫球蛋白(IVIg)抵抗占比及治疗前降钙素原、网膜素-1、趋化因子水平均高于未发生组,IVIg前发热持续时间长于未发生组,血清25(OH)D3低于未发生组(P<0.05)。多因素logistic回归分析结果显示,降钙素原(OR=2.759,95%CI:1.053~4.185)、血清25(OH)D3(OR=0.310,95%CI:0.128~0.754)及趋化因子(OR=3.364,95%CI:2.063~7.125)均为KD患儿发生CAL的影响因素(P<0.05)。受试者操作特征曲线分析显示,血清25(OH)D3联合趋化因子预测KD患儿CAL发生的曲线下面积高于二者单独预测(P<0.05)。结论降钙素原、血清25(OH)D3及趋化因子均为影响KD患儿CAL发生的相关因素,且血清25(OH)D3、趋化因子两者联合对KD患儿CAL发生的预测效能较高。Objective To analyze the influence and prognostic value of serum 25-hydroxyvitamin D3[25(OH)D3]and chemokine on the occurrence of coronary artery lesion(CAL)in children with Kawasaki disease(KD).Methods A total of 86 KD children admitted to the Second People’s Hospital of Wuhu City,Anhui Province from July 2018 to November 2022 were selected as the study objects.After two weeks of treatment,the patients were divided into the occurrence group(21 cases)and the non-occurrence group(65 cases)according to the occurrence of CAL.The clinical data,serum levels of 25(OH)D3,and lipid-derived cytokines were compared between the two groups,and the influencing factors of the occurrence of CAL in KD children were analyzed,and the predictive value of the combined detection of serum 25(OH)D3 and lipid-derived cytokines on the occurrence of CAL in KD children was further analyzed.Results The proportion of KD in acute phase,the proportion of intravenous immunoglobulin(IVIg)resistance,and the levels of procalcitonin,omentin-1,and chemokine before treatment in the occurrence group were higher than those in the non-occurrence group,the duration of fever before IVIg was longer than that in the non-occurrence group,and the serum 25(OH)D3 was lower than that in the non-occurrence group(P<0.05).The results of multivariate logistic regression analysis showed that procalcitonin(OR=2.759,95%CI:1.053-4.185),serum 25(OH)D3(OR=0.310,95%CI:0.128-0.754),and chemokine(OR=3.364,95%CI:2.063-7.125)were the influencing factors of CAL occurrence in KD children(P<0.05).The analysis of the receiver operation characteristic curve showed that the area under the curve of serum 25(OH)D3 combined with chemokine predicted CAL development in KD children was higher than those predicted by the two alone(P<0.05).Conclusion Procalcitonin,serum 25(OH)D3,and chemokine are all related factors affecting the occurrence of CAL in KD children,and the combination of serum 25(OH)D3 and chemokine has a higher predictive effect on the occurrence of CAL in KD children.

关 键 词：川崎病 25-羟维生素D3 脂源性细胞因子 冠状动脉损害 

分 类 号：R725.4[医药卫生—儿科]