摘要
目的探讨单核细胞计数/高密度脂蛋白胆固醇比值(MHR)、闭锁小带蛋白1(ZO1)与川崎病(KD)并发冠状动脉病变(CAL)的关系。方法选取2021年1月至2024年1月该院儿科收治的KD患儿150例为KD组,同期该院体检健康儿童75例为对照组,根据治疗后是否并发CAL将KD患儿分为CAL组和非CAL组,计算MHR和检测ZO1水平。采用多因素非条件Logistic回归模型分析KD患儿并发CAL的影响因素;绘制受试者工作特征(ROC)曲线评价MHR、ZO1预测KD并发CAL的价值。结果与对照组比较,KD组MHR升高,血清ZO1水平降低,差异均有统计学意义(P<0.05)。150例KD患儿CAL发生率为43.33%(65/150),CAL组65例,非CAL组85例。与非CAL组比较,CAL组MHR升高,血清ZO1水平降低,差异均有统计学意义(P<0.05)。发热持续时间≥7 d(OR=4.225,95%CI:1.483~12.041)、静脉注射免疫球蛋白无反应(OR=5.223,95%CI:1.476~18.464)、N末端B型利钠肽前体水平升高(OR=8.980,95%CI:3.052~26.400)、MHR升高(OR=11.928,95%CI:3.891~36.570)水平升高均为KD并发CAL的独立危险因素(P<0.05),ZO1水平升高(OR=0.645,95%CI:0.499~0.748)为KD并发CAL的独立保护因素(P<0.05)。MHR联合ZO1预测KD并发CAL的曲线下面积(AUC)为0.857(95%CI:0.790~0.908),大于MHR、ZO1单独预测的AUC[0.778(95%CI:0.703~0.842)、0.775(95%CI:0.699~0.839)],差异均有统计学意义(P<0.05)。结论KD患儿MHR升高和血清ZO1水平降低与CAL的关系密切,MHR联合ZO1预测KD并发CAL的价值较高。
Objective To investigate the relationship between monocyte count/high-density lipoprotein cholesterol ratio(MHR),zonula occludens-1(ZO1)and Kawasaki disease(KD)complicated with coronary artery lesion(CAL).Methods A total of 150 children with KD admitted to the Department of Pediatrics in Yulin Hospital,First Affiliated Hospital of Xi'an Jiaotong University from January 2021 to January 2024 were selected as the KD group,and 75 healthy children who underwent physical examination at the hospital during the same period were selected as the control group.KD children were divided into CAL group and non-CAL group based on whether they developed CAL after treatment,MHR was calculated and ZO1 levels was detected.Multivariate unconditional Logistic regression model was used to analyzed the influencing factors for KD complicated with CAL.Draw Receiver Operating Characteristic(ROC)curves to evaluate the value of MHR and ZO1 in predicting KD complicated with CAL.Results Compared with the control group,the KD group showed an increase in MHR and a decrease in serum ZO1 level,with statistically significant differences(P<0.05).The incidence rate of CAL in 150 KD children was 43.33%(65/150),with 65 cases in the CAL group and 85 cases in the non-CAL group.Compared with the non-CAL group,the CAL group showed an increase in MHR and a decrease in serum ZO1 level,with statistically significant differences(P<0.05).Fever duration≥7days(OR=4.226,95%CI:1.483—12.041),no response to intravenous immunoglobulin injection(OR=5.220,95%CI:1.476—18.464),increased N-terminal B-type natriuretic peptide precursor(OR=8.976,95%CI:3.052—26.400)and MHR(OR=11.928,95%CI:3.891—36.570)were independent risk factors for KD complicated with CAL,increased ZO1(OR=0.645,95%CI:0.499—0.748)was an independent protective factor for KD complicated with CAL(P<0.05).The area under the curve(AUC)for predicting KD complicated with CAL using MHR combined with ZO1 was 0.857(95%CI:0.790—0.908),which was larger than the 0.778(95%CI:0.703—0.842)and 0.775(95%CI:0.699—0.839)predicted by MHR and ZO1 alone,the difference were significant(P<0.05).Conclusion The increase of MHR and the decrease of serum ZO1 levels in KD children are closely related to CAL,and the combination of MHR and ZO1 has high value in predicting KD complicated with CAL.
作者
郝亚楠
孙婕
李欣
史楠楠
聂沈琴
HAO Ya'nan;SUN Jie;LI Xin;SHI Nannan;NIE Shenqin(Department of Pediatrics,Yulin Hospital,First Affiliated Hospital of Xi'an Jiaotong University,Yulin,Shaanxi 719000,China)
出处
《检验医学与临床》
2025年第14期1932-1937,共6页
Laboratory Medicine and Clinic
基金
陕西省重点研发计划项目(2022-YBSF-417)。
作者简介
郝亚楠,女,主治医师,主要从事儿科学相关疾病研究;通信作者:聂沈琴,E-mail:nsq199002@163.com。
