N末端脑钠肽前体和红细胞分布宽度对川崎病的早期诊断价值

Early diagnostic value of NT-proBNP and RDW levels in early diagnosis of Kawasaki disease

目的:探究N末端脑钠肽前体(NT-proBNP)、红细胞分布宽度(RDW)对川崎病(KD)的早期诊断价值。方法:按是否确诊将92例疑似KD患儿分为KD组(n=48)和非KD组(n=37),比较两组患儿NT-proBNP和RDW等血细胞学及生化指标。采用Logsitic回归模型分析KD发生的独立影响因素,并采用受试者工作特征曲线(ROC)分析NT-proBNP和RDW对KD的早期诊断价值。结果:KD组红细胞沉降率(ESR)、血小板计数(PLT)、白细胞计数(WBC)、RDW、C反应蛋白(CRP)、白细胞介素-6(IL-6)、丙氨酸氨基转移酶(ALT)、乳酸脱氢酶(LDH)、NT-proBNP水平均高于非KD组(P<0.05)。Logistic回归分析显示,ESR(OR=2.646)、PLT(OR=1.049)、RDW(OR=2.138)、NT-proBNP(OR=1.891)均与KD的发生关系密切(P<0.05)。ROC曲线分析显示,NT-proBNP、RDW及二者联合诊断KD的ROC曲线下面积(AUC)分别为0.837、0.711、0.966,以二者联合的诊断价值最大(敏感度=91.67%、特异度=97.30%)。结论:NT-proBNP和RDW均与KD的发生密切相关,可用于KD的早期诊断,且以二者联合应用的诊断价值最高。

Objective:To explore the early diagnostic value of N-terminal pro-brain natriuretic peptide(NT-proBNP) and red blood cell distribution width(RDW) in early diagnosis of Kawasaki disease(KD).Methods:92 children with suspected KD were selected and divided into KD group(n=48) and non-KD group(n=37) according to whether the children were diagnosed with KD.The general data and biochemical indexes(including but not limited to RDW and NT-proBNP) of the two groups were collected and compared.Logsitic regression model was used to analyze the independent influencing factors of KD,and receiver operating characteristic curve(ROC) was used to analyze the early diagnostic value of RDW and NT-proBNP for KD.Results:The erythrocyte sedimentation rate(ESR),platelet count(PLT),white blood cell count(WBC),RDW,C-reactive protein(CRP),interleukin-6(IL-6),alanine aminotransferase(ALT),lactate dehydrogenase(LDH),and NT-proBNP levels in the KD group were significantly higher than those in the non-KD group(P<0.05).Logistic regression analysis showed that ESR(OR=2.646),PLT(OR=1.049),RDW(OR=2.138),NT-proBNP(OR=1.891) were closely related to the occurrence of KD(P<0.05).ROC curve analysis showed that the area(AUC) of NT-proBNP,RDW and their combination in the diagnosis of KD were 0.837,0.711 and 0.966,respectively,and the combination of NT-proBNP and RDW had the highest diagnostic value(sensitivity=91.67%,specificity=97.30%).Conclusion:NT-proBNP and RDW are closely related to the occurrence of KD,which can be used for early diagnosis of KD,and the combination of the two has the highest diagnostic value.