川崎病患儿的降钙素原、白细胞计数和C-反应蛋白与冠状动脉病变的关系

The relationships between procalcitonin, white blood cell count and C-reactive protein and coronary artery lesions in children with Kawasaki disease

目的探讨降钙素原(PCT)、白细胞计数(WBC)和C-反应蛋白(CRP)对川崎病(KD)早期诊断的价值及其与冠状动脉(冠脉)病变(CAL)的关系。方法选择2016年1月—2017年8月湖南省儿童医院收治的226例KD患儿作为KD组,其中85例有CAL(CAL组),141例无CAL(NCAL组)。选择同期住院的170例上呼吸道感染患儿作为感染组;另外选择同期进行健康体检的150例正常儿童作为健康体检组。分别采用一步免疫测定夹心法、全自动免疫比浊法和全自动白细胞计数法,检测3组的PCT、WBC和CRP水平并进行比较,分析上述指标与CAL的关系。结果 KD组患儿的PCT、WBC和CRP水平均明显高于感染组和健康体检组[PCT(μg/L):1.63±2.64比0.84±1.06、0.13±0.19,WBC(×109/L):13.28±5.69比10.85±4.67、7.45±2.46,CRP(mg/L):12.21±7.32比10.72±5.59、2.07±1.13,均P<0.05];CAL组患儿的PCT、CRP水平均明显高于NCAL组[PCT(μg/L):2.74±3.67比1.19±1.85,CRP(mg/L):17.68±6.24比9.01±5.76,均P<0.05],而两组WBC比较差异无统计学意义(P>0.05)。结论 PCT、WBC和CRP早期水平升高与KD密切相关,同时检测PCT和CRP水平对预测CAL具有重要意义。

Objective To investigate the values of procalcitonin（PCT）, white blood cell count（WBC） and C-reactive protein（CRP） in the early diagnosis of Kawasaki disease（KD） and their relationships with coronary artery lesion（CAL）. Methods From January 2016 to August 2017, 226 children with KD in Hunan Children＇s Hospital were selected as KD group, of which 85 cases with CAL（CAL group） and 141 cases without CAL（NCAL group）. 170 children with upper respiratory tract infection hospitalized in the same period as above group were assigned as the infection group, meanwhile, another 150 healthy children having received health screening were recognized as the health screening group. The levels of PCT, WBC and CRP in 3 groups were measured respectively by one step immunoassay sandwich, automatic white blood cell count and automatic turbidimetry, their results were compared and the relationships between those indexes and CAL were analyzed. Results The levels of PCT, WBC and CRP in children of KD group were significantly higher than those in infection group and health examination group [PCT（μg/L）： 1.63±2.64 vs. 0.84±1.06、0.13±0.19, WBC（×109/L）： 13.28±5.69 vs. 10.85±4.67、7.45±2.46, CRP（mg/L）： 12.21±7.32 vs. 10.72±5.59、2.07±1.13, all P〈0.05]; the levels of PCT and CRP in CAL group were significantly higher than those in NCAL group [PCT（μg/L）： 2.74±3.67 vs. 1.19±1.85, CRP（mg/L）： 17.68±6.24 vs. 9.01±5.76, both P〈0.05], while no statistical significant difference in WBC level was seen between the above two groups（P〈0.05）. Conclusion The early elevation of PCT, WBC and CRP levels in the patients are closely related to KD. Simultaneous detections of PCT and CRP are of great significance for predicting CAL.