101例川崎病患儿急性期CRP、PLT水平与肝功能的相关性分析

Correlation analysis of CRP,PLT and liver function in 101 children with Kawasaki disease

目的探讨川崎病患儿C反应蛋白(CRP)、血小板计数(PLT)水平与肝功能的相关性。方法选取该院2012年7月至2019年6月收治的101例川崎病患儿作为病例组,选取同期收治的101例感染性发热疾病患儿作为疾病对照组,选取同期该院101例体检健康儿童作为对照组。检测3组受检者CRP、PLT水平,通过绘制受试者工作特征(ROC)曲线分析CRP、PLT水平对川崎病的评估价值,确定曲线下面积(AUC)、最佳截断值。检测3组受检者的肝功能指标,包括清蛋白(ALB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平。根据是否发生肝损伤,101例川崎病患儿又分成肝损伤组、无肝损伤组,比较两组CRP、PLT、ALB、AST、ALT水平。经Pearson线性相关分析CRP、PLT与各肝功能指标的相关性。结果病例组的CRP、PLT水平高于疾病对照组和对照组,且疾病对照组高于对照组,差异均有统计学意义(P<0.05)。CRP、PLT水平鉴别诊断川崎病、感染性发热的AUC分别为0.772、0.743,二者联合检测的AUC为0.807。病例组ALB水平低于疾病对照组及对照组,AST、ALT水平高于疾病对照组和对照组,差异均有统计学意义(P<0.05)。在101例川崎病患儿中,有29例出现肝损伤,72例无肝损伤。肝损伤组CRP、PLT水平高于无肝损伤组,差异有统计学意义(P<0.05)。CRP、PLT与AST、ALT分别呈正相关(P<0.05),而二者与ALB未见明显相关性(P>0.05)。结论与感染性发热患儿和健康儿童比较,川崎病患儿的CRP、PLT水平明显升高,二者对川崎病与感染性发热的鉴别诊断有一定价值,且CRP、PLT与AST、ALT存在相关性,临床可通过检测CRP、PLT水平,为川崎病诊疗提供依据。

Objective To investigate the correlation between the levels of C-reactive protein(CRP),platelet count(PLT)and liver function in children with Kawasaki disease.Methods A total of 101 children with Kawasaki disease admitted to the hospital from July 2012 to June 2019 were selected as the case group.Another 101 children with infectious fever were included at the same period as the disease control group.A total of 101 healthy children who had physical examination in the hospital at the same time were selected as the control group.The levels of CRP and PLT in three groups were measured.The receiver operating characteristic(ROC)curve of subjects was drawn to analyze the evaluation value of CRP and PLT levels for Kawasaki disease,and the area under the curve(AUC)and the best cut off value were determined.The liver function indexes of three groups,including serum albumin(ALB),aspartate aminotransferase(AST),alanine aminotransferase(ALT)levels were detected in three groups.According to whether there was liver damage in 101 children,they were divided into liver damage group and no liver damage group,and the levels of CRP,PLT,ALB,AST and ALT in the two groups were compared.The correlation between serum CRP,PLT and liver function was analyzed by Pearson linear correlation.Results The levels of CRP and PLT in the case group were significantly higher than those in the disease control group and the control group,and the levels of CRP and PLT in the disease control group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The AUC of serum CRP and PLT level in the differential diagnosis of Kawasaki disease and infectious fever were 0.772 and 0.743 respectively,and the AUC of the combined evaluation of the two was 0.807.The serum ALB level of the case group was lower than those of the disease control group and the control group,and the serum AST and ALT were significantly higher than those of the disease control group and the control group,and the differences were statistically significant(P<0.05).Among 101 children,29(28.71%)had liver damage and 72(71.29%)had no liver damage.Serum CRP and PLT levels in the liver damage group were significantly higher than those in the non-liver damage group,and the differences were statistically significant(P<0.05).Serum CRP and PLT were positively correlated with AST and ALT(P<0.05),but had no correlation with ALB(P>0.05).Conclusion Compared with children with infectious fever and healthy children,serum CRP and PLT levels of children with Kawasaki disease are significantly up-regulated,which are of certain value in the differential diagnosis of Kawasaki disease and infectious fever,and serum CRP and PLT are correlated with AST and ALT respectively.The levels of CRP and PLT can be detected in clinic to provide basis for diagnosis and treatment of Kawasaki disease.