川崎病患儿血清生长分化因子-15趋化素及正五聚蛋白3水平与炎症细胞因子冠状动脉损伤的相关性

Study on the relationship between serum levels of growth differentiation factor-15 and chemokine and pentapmerin 3 and inflammatory factors and coronary artery injury in Kawasaki disease children

目的探讨川崎病(KD)患儿血清生长分化因子-15(GDF-15)、趋化素(Chemerin)及正五聚蛋白3(PTX3)水平与炎症细胞因子、冠状动脉损伤的关系。方法将该院从2017年1月-2020年1月收治的80例KD患儿纳入研究。根据患儿疾病发展情况将其分为急性期组和恢复期组,各80例。另选取同期在院体检的健康儿童50例作为对照组。比较3组血清GDF-15、Chemerin及PTX3以及炎症细胞因子水平,分析血清GDF-15、Chemerin及PTX3与炎症细胞因子的关系。此外,将患儿按照是否出现冠状动脉损伤分为冠状动脉损伤组12例和无冠状动脉损伤组68例,分析KD患儿冠状动脉损伤的影响因素。采用受试者工作特征(ROC)曲线分析血清GDF-15、Chemerin及PTX3预测KD患儿冠状动脉损伤的效能。结果急性期组血清GDF-15、Chemerin、PTX3、白细胞介素(IL)-1、IL-6及C反应蛋白(CRP)水平均高于恢复期组和对照组,且恢复期组上述各项指标水平均高于对照组(均P<0.05)。经Pearson相关性分析可得:血清GDF-15、Chemerin及PTX3与血清IL-1、IL-6及CRP均呈正相关(均P<0.05)。经单因素分析发现:冠状动脉损伤组血清GDF-15、Chemerin、PTX3、IL-1、IL-6及CRP水平均高于无冠状动脉损伤组(均P<0.05)。经多因素Logistic回归分析发现:血清GDF-15、Chemerin、PTX3、IL-1、IL-6及CRP均是KD患儿冠脉损伤的有关影响因素(P<0.05)。ROC曲线显示:血清GDF-15、Chemerin及PTX3联合检测预测KD患儿冠状动脉损伤的曲线下面积、灵敏度以及特异度均较单独预测更高。结论 KD患儿血清GDF-15、Chemerin及PTX3与机体炎症以及冠状动脉损伤相关,可能成为其病情监测的有效标志物。

Objective To study the relationship between serum levels of growth differentiation factor 15(GDF-15),chemokine(Chemerin),pentagostatin 3(PTX3)and inflammatory factors and coronary artery injury in children with Kawasaki disease(KD).Methods A total of 80 children with KD who were admitted to the hospital from January 2017 to January 2020 were included in the study.According to the disease development,the children were divided into acute stage group and convalescence stage group 80 case in each group.Another 50 healthy children who underwent physical examination in our hospital hospital during the same period were selected as the control group.The levels of serum GDF-15,Chemerin,PTX3 and inflammatory factors were compared among the three groups,and the relationship between serum GDF-15,Chemerin,PTX3 and inflammatory factors were analyzed.In addition,according to the presence or absence of coronary artery injury,the children were divided into the coronary artery injury group(n=12)and the non-coronary artery injury group(n=68).The influencing factors of coronary artery injury in children with KD were analyzed.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum GDF-15,Chemerin and PTX3 in predicting coronary artery injury in children with KD.Results The levels of serum GDF-15,Chemerin,PTX3,interleukin-1,IL-6 and C-reactive protein(CRP)in acute period group were higher than those in recovery period group and control group,and the levels of all above indexes in recovery period group were higher than those in control group(all P<0.05).Pearson correlation analysis showed that serum GDF-15,Chemerin and PTX3 were positively correlated with serum IL-1,IL-6 and CRP(all P<0.05).Univariate analysis showed that serum levels of GDF-15,Chemerin,PTX3,IL-1,IL-6 and CRP in the coronary artery injury group were higher than those in the non-coronary artery injury group(all P<0.05).Multivariate Logistic regression analysis showed that serum GDF-15,Chemerin,PTX3,IL-1,IL-6 and CRP were related influencing factors of coronary artery injury in children with KD(P<0.05).The ROC curve showed that the area under the curve,sensitivity and specificity of serum GDF-15,Chemerin and PTX3 combined detection in predicting coronary artery injury in children with KD were higher than those predicted alone.Conclusion Serum GDF-15,Chemerin and PTX3 of children with KD are closely related to inflammatory factors and coronary artery injury,which may be an effective marker for disease monitoring.