血清IL-41及ACE2水平诊断小儿川崎病的临床价值  

Clinical value of serum IL-41 and ACE2 levels in the diagnosis of pediatric Kawasaki disease

作　　者：金程 陆冬慧 张榴榴 谢晋 Jin Cheng;Lu Donghui;Zhang Liuliu;Xie Jin(Department of General Pediatrics,Hefei Maternal and Child Health Hospital,Anhui Province,Hefei 230000,China;不详)

机构地区：[1]安徽省合肥市妇幼保健院普儿科,230000 [2]安徽省合肥市妇幼保健院儿外科,230000

出　　处：《疑难病杂志》2024年第4期467-471,477,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：安徽省卫生健康委科研项目(AHWJ2019b102)。

摘　　要：目的探索川崎病(KD)患儿血清白介素41(IL-41)、血管紧张素转化酶2(ACE2)表达水平及临床诊断价值。方法选取2018年12月—2022年12月合肥市妇幼保健院普儿科诊治KD患儿80例为KD组,根据超声心动图结果,分为冠状动脉损伤(CAL)亚组(n=26)和非CAL亚组(n=54),以同期急性上呼吸道感染伴发热患儿为对照2组(n=40),同期行择期手术的腹股沟斜疝患儿为对照1组(n=40)。采用酶联免疫吸附法检测血清IL-41、ACE2水平;采用Pearson相关分析血清IL-41、ACE2与临床资料的相关性;多因素Logistic回归分析影响KD患儿发生CAL的影响因素;绘制受试者工作特征曲线分析血清IL-41、ACE2预测KD患儿发生CAL的价值。结果血清IL-41、ACE2水平比较,KD组>对照2组>对照1组,差异均有统计学意义(F/P=519.731/<0.001,1115.501/<0.001);KD组患儿血清IL-41、ACE2水平与发热时间、C反应蛋白及降钙素原呈正相关(IL-41:r/P=0.562/<0.001,0.589/<0.001,0.613/<0.001;ACE2:r/P=0.622/<0.001,0.609/<0.001,0.574/<0.001)。CAL亚组发热时间、C反应蛋白、降钙素原、IL-41、ACE2均高于非CAL亚组,差异有统计学意义(t/P=3.459/0.001,11.187/<0.001,11.377/<0.001,12.299/<0.001,25.882/<0.001)。血清IL-41、ACE2、发热时间、C反应蛋白、降钙素原升高是影响KD患儿CAL发生的独立危险因素[OR(95%CI)=1.598(1.271~2.010),1.573(1.241~1.994),1.384(1.142~1.667),1.496(1.171~1.912),1.513(1.159~1.975)]。血清IL-41、ACE2及两项联合预测KD患儿发生CAL的AUC分别0.812、0.815、0.878,两项联合的AUC大于血清IL-41、ACE2单一检测(Z/P=5.116/<0.001、4.217/0.009)。结论KD患儿血清IL-41、ACE2升高,与发热时间、C反应蛋白及降钙素原有关,两者联合对KD患儿CAL发生具有较高的预测价值。Objective To explore the expression level of serum interleukin 41(IL-41)and angiotensin-converting enzyme 2(ACE2)and the clinical diagnostic value of pediatric Kawasaki disease(KD).Methods Eighty cases of KD children diagnosed and treated in the Department of General Pediatrics of Hefei Maternal and Child Health Hospital from December 2018 to December 2022 were selected as the KD group,which were divided into the coronary artery lesion(CAL)subgroup according to echocardiographic results(n=26)and the non-CAL subgroup(n=54),with children with acute upper respiratory tract infection with fever in the same period as control group 2(n=40)and children with inguinal hernia undergoing elective surgery in the same period as control group 1(n=40).The enzyme-linked immunosorbent assay was used to detect the levels of serum IL-41 and ACE2;Pearson's correlation was used to analyze the correlation between serum IL-41 and ACE2 and the clinical data;multifactorial logistic regression was used to analyze the factors affecting the occurrence of CAL in children with KD;and the working characteristic curves of the subjects were plotted to analyze the value of serum IL-41 and ACE2 in predicting the occurrence of CAL in children with KD.The working characteristic curves of subjects were plotted to analyze the value of serum IL-41 and ACE2 in predicting CAL in children with KD.Results Comparison of serum IL-41 and ACE2 levels were as follows:KD group>control 2 group>control 1 group,and the differences were statistically significant(F/P=519.731/<0.001,1115.501/<0.001);IL-41 and ACE2 levels of KD children were positively correlated with fever duration,C-reactive protein and calcitoninogen(IL-41:r/P=0.562/<0.001,0.589/<0.001,0.613/<0.001;ACE2:r/P=0.622/<0.001,0.609/<0.001,0.574/<0.001).The CAL subgroup had higher duration of fever,C-reactive protein,calcitoninogen,and IL-41,ACE2 were higher than those in the non-CAL subgroup,and the differences were statistically significant(t/P=3.459/0.001,11.187/<0.001,11.377/<0.001,12.299/<0.001,25.882

关 键 词：川崎病 白介素41 血管紧张素转化酶2 诊断 儿童 

分 类 号：R725.4[医药卫生—儿科]