生物学标志物对儿童川崎病诊断价值的研究  

Study on value of biological markers in diagnosis of Kawasaki disease in children

作　　者：武爱敏[1] 沈永明[1] WU Aimin;SHEN Yongming(Department of Clinical Laboratory,Tianjin Municipal Children’s Hospital/Children’s Hospital of Tianjin University,Tianjin 300134,China)

机构地区：[1]天津市儿童医院/天津大学儿童医院检验科,天津300134

出　　处：《重庆医学》2024年第24期3752-3755,共4页Chongqing Medical Journal

基　　金：天津市医学重点学科(专科)建设项目(TJYXZDXK-040A)。

摘　　要：目的筛选辅助检查儿童川崎病(KD)的生物学标志物。方法选取2022年1月至2023年12月于该院住院的208例初发KD患儿作为KD组,另选取于该院健康查体的208例健康儿童作为对照组,检测两组血清C反应蛋白(CRP)、WBC、PLT、红细胞沉降率(ESR)、降钙素原(PCT)、抗链球菌溶血素O(ASO)、白细胞介素-6(IL-6)、免疫球蛋白(Ig)G、IgA、IgM、IgE、补体C3、补体C4、血清铁蛋白(Fer)水平,并用受试者工作特征(ROC)曲线评价各生物学标志物对KD诊断的价值。结果KD组CRP、WBC、PLT、ESR、PCT、IL-6、IgM、补体C4、Fer水平高于对照组,差异有统计学意义(P<0.05)。ROC曲线显示,CRP、WBC、ESR、PCT、IL-6曲线下面积(AUC)均>0.9,其中CRP的AUC为1.000,以2.25 ng/L为截断值时的灵敏度为100.0%,特异度为100.0%;IL-6的AUC为0.998,以6.595 mg/L为截断值时的灵敏度为97.1%,特异度为99.0%;ESR的AUC为0.987,以18.50 mm/h为截断值时的灵敏度为96.0%,特异度为99.0%。结论CRP、IL-6和ESR具有较高的KD诊断价值。Objective To screen the biological markers in the assisted detection of childhood Kawasaki disease(KD).Methods A total of 208 children inpatients initially diagnosed as KD in this hospital from January 2022 to December 2023 were selected as the KD group,and 208 healthy children undergoing physical examination in this hospital were selected as the control group.Serum C reactive protein(CRP),white blood cells(WBC),platelets(PLT),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),antistreptolysin O(ASO),interleukin-6(IL-6),immunoglobulin IgG,IgA,IgM,IgE,complement C3,C4 and serum ferritin(Fer)in the two groups were detected,and the receiver operating characteristic(ROC)curve was used to evaluate the value of the various biological indexes for diagnosing KD.Results The levels of CRP,WBC,PLT,ESR,IgM,complement C4,Fer,PCT and IL-6 in the KD group were higher than those in the control group,and the differences were statistically significant(P<0.05).The ROC curve showed that the areas under the curves(AUC)of CRP,WBC,ESR,PCT and IL-6 all were>0.9,in which,AUC of CRP was 1.000,when 2.25 ng/L was the cut-off value,the sensitivity and specificity were 100.0%.AUC of IL-6 was 0.998,when 6.595 mg/L was the cut-off value,the sensitivity was 97.1%and the specificity was 99.0%.AUC of ESR was 0.987,when 18.50 mm/h was the cut-off value,the sensitivity was 96.0%and the specificity was 99.0%.Conclusion CRP,IL-6 and ESR have the higher diagnostic value for KD.

关 键 词：川崎病 标志物 C反应蛋白 ROC曲线 儿童 

分 类 号：R725.4[医药卫生—儿科]