川崎病患者急性期血清降钙素原水平的变化和临床意义

Clinical significance of serum procalcitotin in children with Kawasaki disease at acute stage

目的评价川崎病(KD)患者急性期血清降钙素原(PCT)水平的变化和临床意义。方法回顾分析120例KD患儿急性期血清PCT水平和治疗前后的变化。根据超声心动图结果,将全部患儿分为冠状动脉损伤(CAL)组和无冠状动脉损伤(NCAL)组;根据是否存在胃肠道症状(A组:是,B组:否)组及是否存在肝功能异常(C组:是,D组:否)组。比较各分组之间PCT水平的差异。结果急性期血清PCT在治疗前高于正常值的患儿共有56例(46.67%),治疗后血清PCT明显下降,差异有统计学意义(P<0.05)。120例KD患儿中CAL组共31例,其PCT升高率(38.71%)与NCAL组(49.44%)差异无统计学意义,CAL组与NCAL组血清PCT值差异亦无统计学意义。CAL组患儿C反应蛋白水平高于NCAL组。120例KD患儿中有胃肠道症状者共35例,其PCT升高率(62.86%)与无胃肠道症状组(40.00%)差异有统计学意义(P<0.05),此2组间血清PCT水平差异无统计学意义。120例KD患儿中有肝功能异常者共42例,其PCT升高率(52.38%)与无肝功能异常组(43.59%)差异无统计学意义,血清PCT值在此2组间差异亦无统计学意义。结论 PCT可以反映KD患者急性期的炎症状态,其水平升高不能预测CAL和肝功能异常的发生,但与胃肠道症状的出现或许有关。

Objective To investigate the changes and clinical significance of serum procalcitonin（PCT） level inchildren with acute phase of Kawasaki disease（KD）. Methods The serum PCT levels and their changes before and afterthe treatment in 120 children with KD at acute phase were retrospectively analyzed. According to the results of ultrasonicechocardiography, all children were divided into coronary artery damage（CAL） group and no coronary artery lesion（NCAL）group. According to the presence of gastrointestinal symptoms, patients were divided into two groups（A： yes and B： no）.According to the presence of abnormal liver function, patients were divided into two groups（C： yes and D： no）. PCT levelswere compared between groups. Results The serum PCT levels were increased at acute phase in 56（46.67%） patientsbefore the treatment than those in normal children, which were decreased obviously after treatment（P〈0.05）. There were 31 cases combined with CAL, the rising rate of PCT was 38.71%, which was no significant difference compared with that ofNCAL group（49.44%, P〉0.05）. There was no significant difference in serum PCT value between CAL group and NCALgroup（P〉0.05）. The serum C-reactive protein level was significantly higher in CAL group than that of NCAL group. Therewere 35 patients combined with gastrointestinal symptoms in 120 KD patients. There was no significant difference in therising rate of PCT between patients with gastrointestinal symptoms（62.86%） and patients without gastrointestinal symptoms（40.00%, P〈0.05）. There was no significant difference in serum PCT level between these two groups of patients. There were42 cases with liver dyfunction in 120 KD patients, the PCT rising rate（52.38%） was no statistically significant differencecompared with that of patients with no liver dyfunction（43.59%, P〉0.05）. And there was no significant difference in serumPCT value between the two groups（P〉0.05）. Conclusion PCT can reflect the acute phase of KD patients. The increasedPCT level may be related with the emergence of gastrointestinal symptoms, even though it cannot predict CAL and theoccurrence of liver damage.