川崎病患儿血清CaN、NFATc1水平与免疫球蛋白治疗反应的相关性

Correlation Between Serum CaN,NFATc1 Levels and Immunoglobulin Treatment Response in Children with Kawasaki Disease

目的探讨川崎病患儿血清钙调神经磷酸酶(CaN)、活化T细胞核因子c1(NFATc1)水平与免疫球蛋白(IVIG)治疗反应的相关性,以期为临床改善治疗效果提供理论参考。方法采用前瞻性研究,选取平顶山市第一人民医院2018年1月至2023年1月100例川崎病患儿作为研究对象,检测入院时患儿的血清CaN、NFATc1水平,同时收集患儿的一般资料,根据IVIG治疗反应情况分为IVIG治疗敏感组与IVIG治疗无反应组。比较两组患儿的血清CaN、NFATc1水平及一般资料,采用点二列相关性检验血清CaN、NFATc1水平与IVIG治疗反应之间的关系,并采用logistic回归性检验二者对IVIG治疗反应的影响。结果100例患儿中有20例为IVIG治疗无反应,占比为20%(20/100)。IVIG治疗无反应组患儿入院时血清CaN、NFATc1及C反应蛋白(CRP)水平高于IVIG治疗敏感组(P<0.05)。经点二列相关性检验显示血清CaN、NFATc1水平与川崎病患儿IVIG治疗无反应存在正相关关系(r>0,P<0.05)。经logistic回归性分析检验显示高水平血清CaN、血清NFATc1是导致患儿IVIG治疗无反应的影响因素(P<0.05)。结论川崎病患儿IVIG治疗无反应发生风险较高,且与血清CaN、血清NFATc1存在关系,二者的高水平表达是导致IVIG治疗无反应的影响因素。

Objective To investigate the correlation between serum levels of calcineurin(CaN),nuclear factor of activated T cells c1(NFATc1)and immunoglobulin(IVIG)treatment responsiveness in children with Kawasaki disease,in order to provide theoretical reference for clinical improvement of treatment efficacy.Methods A prospective cohort study was conducted to select 100 children with Kawasaki disease from Pingdingshan First People’s Hospital from January 2018 to January 2023.The levels of serum CaN and NFATc1 were detected at admission,and the general data of the children were collected.According to the response to IVIG treatment,the children were divided into IVIG sensitive group and IVIG non-responsive group.Serum CaN and NFATc1 levels and general data were compared between the two groups.The relationship between serum CaN and NFATc1 levels and IVIG treatment response was tested by point two column correlation,and the effect of the two on IVIG treatment response was tested by logistic regression.Results Among the 100 patients,20 were unresponsive to IVIG treatment,accounting for 20%(20/100).The levels of serum CaN,NFATc1 and C-reactive protein(CRP)in the IVIG non-responsive group were higher than those in the IVIG sensitive group at admission(P<0.05).The point two column correlation test showed a positive correlation between serum CaN and NFATc1 levels and no response to IVIG treatment in children with Kawasaki disease(r>0,P<0.05).Logistic regression analysis showed that high levels of serum CaN and serum NFATc1 were the influencing factors leading to unresponsiveness to IVIG treatment in children(P<0.05).Conclusion Children with Kawasaki disease have a higher risk of unresponsiveness after IVIG treatment,and there is a relationship between them and serum CaN and NFATc1.The high expression of both is a contributing factor to the unresponsiveness of IVIG treatment.