C反应蛋白、中性粒细胞、谷丙转氨酶、白蛋白、血钠、肌酸激酶同工酶对川崎病冠状动脉损害的风险评估  

Risk assessment of coronary artery lesion by C-reactive protein,neutrophils,alanine aminotransferase,albumin,blood sodium and creatine kinase isoenzyme in Kawasaki disease

作　　者：吴庆平[1] 王连珍 钟笃勇 陈永洁 杨群 WU Qingping;WANG Lianzhen;ZHONG Duyong;CHEN Yongjie;YANG Qun(Department of Pediatrics,Ji'an Maternal and Child Health Hospital,Jiangxi Province,Ji'an 343000,China)

机构地区：[1]江西省吉安市妇幼保健院儿科,江西吉安343000

出　　处：《中国当代医药》2025年第7期19-22,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202410996)。

摘　　要：目的探讨C反应蛋白(CRP)、中性粒细胞、谷丙转氨酶(ALT)、白蛋白、血钠、肌酸激酶同工酶(CK-MB)对川崎病(KD)冠状动脉损害(CAL)的风险评估价值。方法回顾性分析2021年1月至2023年12月吉安市妇幼保健院收治的100例KD患儿病历资料。将其按照是否并发CAL分作并发CAL组(n=50)及单纯KD组(n=50)。比较两组性别、年龄以及CRP、中性粒细胞、ALT、白蛋白、血钠、CK-MB水平。选用多因素logistic回归分析明确KD患儿并发CAL的影响因素。借助受试者工作特征(ROC)曲线明确CRP、中性粒细胞、ALT、白蛋白、血钠、CK-MB预测KD患儿并发CAL的效能。结果单因素分析结果显示,两组CRP、白蛋白、血钠、CK-MB水平比较,差异有统计学意义(P<0.05)。多因素分析结果显示,CRP(β=0.253,OR=1.287,95%CI:1.045~3.102)、CK-MB(β=0.122,OR=1.130,95%CI:1.005~2.038)均是KD患儿并发CAL的独立危险因素,而白蛋白(β=-0.133,OR=0.876,95%CI:0.682~0.958)、血钠(β=-0.079,OR=0.924,95%CI:0.845~0.997)均是KD患儿并发CAL的独立保护因素(P<0.05)。经ROC曲线分析证实,CRP、白蛋白、血钠、CK-MB水平联合预测KD患儿并发CAL的效能较单一指标更佳。结论CRP、白蛋白、血钠、CK-MB对KD患儿并发CAL风险评估中均有一定价值,且联合检测价值更高。Objective To investigate the risk assessment value of C-reactive protein(CRP),neutrophils,alanine transferase(ALT),albumin,blood sodium,creatine kinase isoenzyme(CK-MB)in coronary artery damage(CAL)in Kawasaki disease(KD).Methods The medical records of 100 KD children admitted to Ji'an Maternal and Child Health Hospital from January 2021 to December 2023 were retrospectively analyzed.They were divided into concurrent CAL group(n=50)and simple KD group(n=50)according to whether there was concurrent CAL or not.Gender,age,CRP,neutrophils,ALT,albumin,blood sodium and CK-MB levels were compared between the two groups.Multivariate logistic regression analysis was used to determine the influencing factors of CAL in KD children.The efficacy of CRP,neutrophils,ALT,albumin,blood sodium and CK-MB in predicting CAL in children with KD was determined by receiver operating characteristic(ROC)curve.Results The results of single factor analysis indicated that the levels of CRP,albumin,blood sodium and CK-MB were significantly different between the two groups(P<0.05).Multivariate analysis indicated that CRP(β=0.253,OR=1.287,95%CI:1.045-3.102)and CK-MB(β=0.122,OR=1.130,95%CI:1.005-2.038)were independent risk factors for CAL in KD children.Albumin(β=-0.133,OR=0.876,95%CI:0.682-0.958)and blood sodium(β=-0.079,OR=0.924,95%CI:0.845-0.997)were independent protective factors for CAL in children with KD(P<0.05).ROC curve analysis confirmed that CRP,albumin,blood sodium and CK-MB combined levels were more effective than single indicators in predicting CAL complications in KD children.Conclusion CRP,albumin,blood sodium and CK-MB all have certain value in the risk assessment of complicated CAL in KD children,and the combined detection value is higher.

关 键 词：川崎病 冠状动脉损害 C反应蛋白 中性粒细胞 谷丙转氨酶 白蛋白 血钠 肌酸激酶同工酶 

分 类 号：R72[医药卫生—儿科]