川崎病合并MP感染患儿冠状动脉损伤及炎症因子水平  

Coronary artery damage and levels of inflammatory factors in children with Kawasaki disease combined with MP infection

作　　者：梁鹏 娄莹 崔怀亮 杨成胜 杨庆华 LIANG Peng;LOU Ying;CUI Huai-liang;YANG Cheng-sheng;YANG Qing-hua(Fourth Clinical College of Xinziang Medical College,Xinriang Central Hospital,Xinriang,Henan 453000,China)

机构地区：[1]新乡市中心医院(新乡医学院第四临床学院)儿科二病区,河南新乡453000

出　　处：《中华医院感染学杂志》2023年第19期3013-3017,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划省部共建青年基金资助项目(SB201904015)。

摘　　要：目的探讨川崎病(KD)合并肺炎支原体(MP)感染患儿冠状动脉损伤和炎症因子水平。方法选取2020年6月-2022年6月新乡市中心医院收治的KD合并MP感染患儿32例(MP组)和无感染KD患儿64例(KD组),比较两组KD患儿CAL异常率,常规检测患儿实验室指标,酶联免疫吸附试验检测患儿外周血白细胞介素-4(IL-4)、IL-2、IL-6、IL-10、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)水平,分析IL-4、IL-2、IL-6、IL-10、IFN-γ、TNF-α水平与KD患儿CAL情况的相关性,采用受试者工作特征(ROC)曲线分析炎症介质水平对KD合并MP感染的诊断效能。结果MP组患儿住院时间长于KD组(P<0.001),MP组患儿中CAL发生率为59.38%高于KD组(P=0.008);MP组患儿C-反应蛋白(CRP)、红细胞沉降率(ESR)、IL-4、IL-2、IL-6、IL-10、IFN-γ、TNF-α水平高于KD组(P<0.001),且CRP、ESR、IL-4、IL-2、IL-6、IL-10、IFN-γ、TNF-α与冠状动脉内径绝对值呈正相关(P<0.001);IL-4、IL-2、IL-6、IL-10、IFN-γ、TNF-α曲线下面积(AUC)分别0.728、0.757、0.783、0.816、0.787、0.798(P<0.001)。结论MP感染会升高KD患儿CAL发生概率以及炎症介质水平,且炎症介质水平还与CAL程度存在关系、还可用于KD合并MP感染辅助诊断。OBJECTIVE To investigate coronary artery lesions(CAL)abnormalities and inflammatory factor levels in children with Kawasaki disease(KD)combined with Mycoplasma pneumoniae(MP)infection.METHODS A total of 32 children with KD combined with MP infection(MP group)and 64 KD children without MP infection(KD group)admitted to Xinxiang Central Hospital between Jun.2020 and Jun.2022 were selected.The incidence of CAL in the two groups was compared.The laboratory indexes of children were routinely detected.The levels of peripheral blood interleukin(IL)-4,IL-2,IL-6,IL-10,interferon(IFN-γ)and tumor necrosis factor-α(TNF-α)were detected by enzyme-linked immunosorbent assay,and their correlation with CAL in KD children was analyzed.The diagnostic efficiency of inflammatory mediators for KD combined with MP infection was analyzed by receiver operating characteristic(ROC)curves.RESULTS The hospitalization time in MP group was longer than that in KD group(P<0.001),incidence of CAL was 59.38%,higher than that in KD group(P=0.008),and levels of C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),IL-4,IL-2,IL-6,IL-10,IFN-γ and TNF-αwere higher than those in KD group(P<0.001).The levels of CRP,ESR,IL-4,IL-2,IL-6,IL-10,IFN-γ and TNF-αwere positively correlated with absolute value of coronary artery diameter(P<0.001).The area under the curve(AUC)values of IL-4,IL-2,IL-6,IL-10,IFN-γ and TNF-αwere 0.728,0.757,0.783,0.816,0.787 and 0.798,respectively(P<0.001).CONCLUSION MP infection might increase the incidence of CAL and levels of inflammatory mediators in children with KD.The levels of inflammatory mediators were related to the severity of CAL,which could also be used as an aid to the diagnosis of KD combined with MP infection.

关 键 词：川崎病 肺炎支原体肺炎 冠状动脉损伤 白细胞介素-4 白细胞介素-2 白细胞介素-6 白细胞介素-10 干扰素-Γ 肿瘤坏死因子-α 

分 类 号：R446[医药卫生—诊断学]