动态心电图及sST2、PAI-1在川崎病伴发冠脉损伤诊断中的研究  

Study on the Diagnosis of Kawasaki Disease with Coronary Artery Lesions using Dynamic Electrocardiogram and sST2,PAI-1

作　　者：陈晓光[1] 窦冰华[1] CHEN Xiaoguang;DOU Binghua(Department of Pediatrics,The First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450000,China)

机构地区：[1]郑州大学第一附属医院小儿内科,河南郑州450000

出　　处：《临床研究》2024年第8期153-156,共4页Clinical Research

摘　　要：目的探讨动态心电图及可溶性人基质裂解素-2(sST2)、纤溶酶原激活物抑制物-1(PAI-1)在川崎病伴发冠脉损伤诊断中的意义。方法研究对象选取2018年1月至2024年1月郑州大学第一附属医院收治的102例川崎病患儿,根据患儿是否伴发冠脉损伤分为两组,其中损伤组40例,未损伤组62例。比较两组患儿的临床病例资料[性别、年龄、身体质量指数(BMI)、发热持续时间、白细胞计数、25-羟维生素D3(25-(OH)D_(3))、血红蛋白、血小板计数、肌酸激酶同工酶(CK-MB)、氨基末端脑利钠肽前体(NT-proBNP)、C反应蛋白(CRP)、sST2、PAI-1]及动态心电图异常率,通过多因素分析川崎病伴发冠脉损伤的影响因素,绘制ROC曲线评价不同指标对川崎病患儿伴发冠脉损伤的诊断价值。结果损伤组患儿的发热持续时间、血小板计数、CRP、CK-MB、NT-proBNP、sST2、PAI-1水平高于未损伤组,25-(OH)D_(3)水平低于未损伤组,差异具有统计学意义(P<0.05)。损伤组患儿的动态心电图异常率为60.00%,未损伤组患儿的动态心电图异常率为16.13%,损伤组高于未损伤组,差异具有统计学意义(P<0.05)。二元Logistic分析结果显示,发热持续时间、25-(OH)D_(3)、血小板计数、CRP、CK-MB、NT-proBNP、sST2、PAI-1、动态心电图异常是川崎病患儿伴发冠脉损伤的影响因素(P<0.05)。以sST2、PAI-1、动态心电图异常及3项指标联合应用作为变量绘制诊断川崎病伴发冠脉损伤的ROC曲线,sST2的AUC为0.789,PAI-1的AUC为0.729,动态心电图异常的AUC为0.719,联合检测的AUC为0.978。结论动态心电图及sST2、PAI-1水平诊断川崎病是否伴发CAL具有较高的诊断价值。Objective To explore the significance of dynamic electrocardiogram and soluble suppression of tumorigenicity 2(sST2),plasminogen activator inhibitor-1(PAI-1)in the diagnosis of Kawasaki disease with coronary artery lesions.Methods A total of 102 children with Kawasaki disease treated in The First Affiliated Hospital of Zhengzhou University from January 2018 to January 2024 were selected as research subjects.According to whether the children had coronary artery lesions,they were divided into two groups:the lesion group(40 cases)and the non-lesion group(62 cases).The clinical case data[gender,age,body mass index(BMI),duration of fever,white blood cell count,25-hydroxyvitamin D3(25-(OH)D3),hemoglobin,platelet count,creatine kinase isoenzyme(CK-MB),N-terminal pro-brain natriuretic peptide(NT-proBNP),C-reactive protein(CRP),sST2,PAI-1]and the abnormal rate of dynamic electrocardiogram were compared between the two groups.The influencing factors of Kawasaki disease with coronary artery lesions were analyzed by multiple factors,and the ROC curve was drawn to evaluate the diagnostic value of different indicators for Kawasaki disease with coronary artery lesions.Results The duration of fever,platelet count,CRP,CK-MB,NT-proBNP,sST2,PAI-1 levels in the lesion group were higher than those in the non-lesion group,and the level of 25-(OH)D3 was lower than that in the non-lesion group,the differences were statistically significant(P<0.05).The abnormal rate of dynamic electrocardiogram in the lesion group was 60.00%,and that in the non-lesion group was 16.13%.The lesion group was higher than the non-lesion group,and the difference was statistically significant(P<0.05).The results of binary Logistic analysis showed that the duration of fever,25-(OH)D3,platelet count,CRP,CK-MB,NT-proBNP,sST2,PAI-1,and abnormal dynamic electrocardiogram were the influencing factors of Kawasaki disease with coronary artery lesions(P<0.05).The ROC curve of diagnosing Kawasaki disease with coronary artery lesions was drawn with sST2,PAI-1,abnormal dyn

关 键 词：动态心电图 可溶性人基质裂解素-2 纤溶酶原激活物抑制物-1 川崎病 冠脉损伤 

分 类 号：R540.41[医药卫生—心血管疾病]