摘要
目的探讨血清白细胞介素10(IL-10)、B型利尿钠肽(BNP)水平与小儿川崎病(KD)严重程度及冠状动脉损伤(CAL)的关系。方法选取2021年11月至2023年12月华中科技大学同济医学院附属武汉儿童医院收治的120例KD患儿作为研究组,另选同期体检健康儿童60例作为对照组。根据是否存在CAL将研究组分为CAL组(37例)和非CAL组(83例);根据CAL严重程度将CAL组分为轻度组(16例)、中度组(12例)和重度组(9例);检测所有研究对象血清IL-10、BNP水平;采用受试者工作特征(ROC)曲线分析血清IL-10、BNP水平对小儿KD发生CAL的预测价值;采用多因素Logistic逐步回归分析小儿KD发生CAL的影响因素。结果研究组血清IL-10、BNP高于对照组(P<0.05)。CAL组小儿KD血清IL-10低于非CAL组,BNP水平及冠状动脉内径高于非CAL组(P<0.05)。血清IL-10与小儿KD冠状动脉内径呈负相关,血清BNP与小儿KD冠状动脉内径呈正相关(P<0.05)。血清IL-10、BNP联合预测小儿KD发生CAL的曲线下面积为0.903,高于血清IL-10、BNP单独预测的0.724、0.857(P<0.05)。中度组、重度组血清IL-10低于轻度组,血清BNP高于轻度组(P<0.05);重度组血清IL-10低于中度组,血清BNP高于中度组(P<0.05)。多因素分析显示,长发热时间、高CRP、高BNP是小儿KD发生CAL的独立危险因素(P<0.05),高IL-10是小儿KD发生CAL的独立保护因素(P<0.05)。结论KD患儿血清IL-10、BNP水平与其CAL发生及CAL严重程度密切相关,联合检测血清IL-10、BNP水平可预测CAL发生。
Objective To explore the relationship between serum interleukin-10(IL-10)and B-type natriuretic peptide(BNP)levels and the severity of Kawasaki disease(KD)and coronary artery lesions(CAL)in children.Methods A total of 120 children with KD admitted to Tongji Hospital of Wuhan Children's Hospital,Huazhong University of Science and Technology from November 2021 to December 2023 were selected as the study group,and another 60 healthy children undergoing physical examinations during the same period were selected as the control group.The study group was divided into the CAL group(37 cases)and the non-CAL group(83 cases)based on the presence or absence of CAL.The CAL group was further divided into the mild group(16 cases),the moderate group(12 cases),and the severe group(9 cases)based on CAL severity.Serum IL-10 and BNP levels were detected in all subjects.The predictive value of serum IL-10 and BNP levels for CAL occurrence in children with KD was analyzed using the receiver operating characteristic(ROC)curve.Multivariate Logistic stepwise regression was used to analyze influencing factors for CAL in children with KD.Results Serum IL-10 and BNP levels in the study group were higher than those in the control group(P<0.05).Serum IL-10 level in the CAL group was lower than that in the non-CAL group,while BNP level and coronary artery diameter were higher than those in the non-CAL group(P<0.05).Serum IL-10 was negatively correlated with coronary artery diameter in children with KD,while serum BNP was positively correlated with coronary artery diameter(P<0.05).The area under the curve(AUC)for combined serum IL-10 and BNP in predicting CAL occurrence in children with KD was 0.903,significantly higher than the AUCs for IL-10(0.724)and BNP(0.857)alone(P<0.05).Serum IL-10 levels in the moderate and severe groups were lower than those in the mild group,while serum BNP levels were higher than those in the mild group(P<0.05);serum IL-10 in the severe group was lower than that in the moderate group,and serum BNP was higher than that in the moderate group(P<0.05).Multivariate analysis showed that long fever duration,high CRP,and high BNP were independent risk factors for CAL in children with KD(P<0.05),while high IL-10 was an independent protective factor(P<0.05).Conclusion Serum IL-10 and BNP levels in children with KD are closely related to the occurrence and severity of CAL.Combined detection of serum IL-10 and BNP levels can predict CAL occurrence.
作者
夏琨
张勇
周丹
付佳
张华勇
XIA Kun;ZHANG Yong;ZHOU Dan;FU Jia;ZHANG Huayong(Department of Cardiovascular Medicine,Wuhan Children's Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430016,China)
出处
《转化医学杂志》
2025年第7期74-78,共5页
Translational Medicine Journal
基金
湖北省卫生健康委员会科研项目(WJ2021M019)。
作者简介
通信作者:夏琨,本科,副主任医师。主要从事儿童心血管疾病方向研究,E-mail:xiakunwhy@163.com。
