高迁移率族蛋白B1和中性粒细胞弹性蛋白酶在川崎病及其冠状动脉病变诊断与预测中的价值研究  

The value of high mobility group box-1 and neutrophil elastase in the diagnosis and prediction of Kawasaki disease and coronary artery lesions

作　　者：原丽霞 王飞 徐慧 薛莹 田静 牛玲 Yuan Lixia;Wang Fei;Xu Hui;Xue Ying;Tian Jing;Niu Ling(Department of Cardiovascular Medicine,Xuzhou Children's Hospital,Xuzhou Medical University,Xuzhou221002,China)

机构地区：[1]徐州医科大学附属徐州儿童医院心血管内科,221002

出　　处：《国际儿科学杂志》2024年第11期776-780,共5页International Journal of Pediatrics

基　　金：徐州市财政局科技计划项目(KC23199)。

摘　　要：目的探讨高迁移率族蛋白B1(high mobility group box-1,HMGB1)、中性粒细胞弹性蛋白酶(neutrophil elastase,NE)在早期识别川崎病(Kawasaki disease,KD)及预测冠状动脉病变(coronary artery lesions,CAL)中的临床价值。方法采用病例对照研究方法,选取2022年9月至2023年10月于徐州医科大学附属徐州儿童医院心血管内科住院治疗的80例KD患儿作为KD组,并依据心脏彩色超声冠状动脉检查结果将KD组分为CAL组和非CAL(NCAL)组。另外,纳入同期入院的诊断为呼吸道感染性疾病的发热患儿和健康体检儿童各40例作为普通发热对照组和健康对照组。采用单因素方差分析、最小显著差异法及Bonferroni校正比较KD组、普通发热对照组、健康对照组血清HMGB1、NE水平,同时比较KD组急性期、亚急性期、恢复期血清HMGB1、NE水平变化。应用独立样本t检验比较CAL组、NCAL组在急性期、亚急性期、恢复期的水平差异。绘制受试者工作特征曲线分析血清HMGB1、NE对早期识别KD及预测KD合并CAL的价值。结果KD组急性期患儿血清HMGB1、NE水平显著高于对照组,差异有统计学意义(F=60.962、45.805,均P<0.05)。KD组患儿血清HMGB1、NE水平急性期高于亚急性期和恢复期,差异有统计学意义(F=14.369、26.641,均P<0.05)。CAL组患儿急性期、亚急性期及恢复期血清HMGB1、NE水平均高于NCAL组,差异有统计学意义(t=-3.086、-3.055、-3.321、-5.212、-2.647、-2.345,均P<0.05)。HMGB1、NE对早期识别KD的最佳临界值分别为2.04μg/L和241.00μg/L。HMGB1、NE及联合检测用于早期识别KD的曲线下面积分别为0.89、0.85、0.90,所对应的灵敏度分别为87.50%、71.30%、75.00%,特异度分别为81.20%、90.00%、92.50%。KD组急性期血清HMGB1、NE对预测CAL的最佳临界值分别为2.60μg/L和261.00μg/L,HMGB1、NE及联合检测预测CAL的曲线下面积分别为0.70、0.80、0.81,所对应的灵敏度分别为63.60%、86.40%、72.70%,特异度分别�Objective To explore the clinical value of high mobility group box-1(HMGB1)and neutrophil elastase(NE)in early detection of Kawasaki disease(KD)and prediction of coronary artery lesions(CAL).Method In this case-control study,80 children with Kawasaki disease who were hospitalized in the Department of Cardiovascular Medicine,Xuzhou Children's Hospital,Xuzhou Medical University from September 2022 to October 2023 were selected as the KD group,and they were further divided into the CAL subgroup and the non-CAL(NCAL)subgroup according to the color echocardiography results of coronary artery.Additionally,40 children with fever diagnosed as respiratory infectious diseases and 40 healthy children for general health check-ups during the same period were enrolled as the fever control group and the healthy control group,respectively.The one-way ANOVA,least significant difference(LSD)method and Bonferroni correction were used to compare the serum HMGB1 and NE levels in KD group,fever control group and healthy control group as well as the changes of serum HMGB1 and NE levels in acute,sub-acute and convalescence stages of KD group.The independent sample t-test was applied to compare the differences between CAL subgroup and NCAL subgroup at acute,sub-acute and convalescence stages.The receiver operating characteristic curve was drawn to analyze the value of serum HMGB1 and NE for early detection of KD and prediction of KD with CAL.Results In the acute stage,the serum levels of HMGB1 and NE of children with KD were significantly higher than those of the two control groups,with statistically significant differences(F=60.962,45.805,all P<0.05).The serum levels of HMGB1 and NE of the KD group were higher in the acute stage than those in the sub-acute stage and the convalescence stage,with statistically significant differences(F=14.369,26.641,all P<0.05).The serum levels of HMGB1 and NE of the CAL subgroup were higher than those of the NCAL subgroup in the acute,sub-acute and convalescence stage,with statistically significant diffe

关 键 词：川崎病 冠状动脉病变 高迁移率族蛋白B1 中性粒细胞弹性蛋白酶 

分 类 号：R725.4[医药卫生—儿科]