RDW/ESR、Chemerin、IL-13与急性期川崎病冠脉扩张的相关性

Relationship between RDW/ESR,Chemerin,IL-13 and Coronary Artery Dilatation in Acute Kawasaki Disease

【目的】探讨红细胞分布宽度与血沉比值(RDW/ESR)、趋化素(Chemerin)、白介素-13(IL-13)与急性期川崎病冠脉扩张的相关性。【方法】选取2016年8月至2020年8月本院收治的135例急性期川崎病患儿,根据是否出现冠脉扩张分为扩张组(n=28)、无扩张组(n=107)。比较两组基线资料及RDW/ESR、Chemerin、IL-13,采用多因素Logistic回归方程分析冠脉扩张的相关影响因素,并比较静脉注射丙种球蛋白(IVIG)不同治疗反应性的患儿RDW/ESR、Chemerin、IL-13水平,采用受试者工作特征曲线(ROC曲线)分析各指标及联合预测治疗反应性的价值。【结果】扩张组RDW/ESR、Chemerin、IL-13高于无扩张组(P<0.05);多元Logistic回归分析显示,RDW/ESR、Chemerin、IL-13均与冠脉扩张有关(P<0.05)。治疗敏感的患儿Chemerin、IL-13低于不敏感患儿(P<0.05)。ROC曲线显示,Chemerin、IL-13联合预测IVIG治疗反应性的AUC高于单独预测,AUC为0.891。【结论】RDW/ESR、Chemerin、IL-13均与急性期川崎病患儿冠脉扩张有关,且Chemerin、IL-13可有效预测静脉注射IVIG的治疗反应性,为及时采取有效、个体化治疗提供依据。

【Objective】To investigate the relationship between the level of red blood cells distribution width/erythrocyte sedimentation rate(RDW/ESR),Chemerin,interleukin-13(IL-13)and coronary dilatation in acute Kawasaki disease.【Methods】A total of 135 children with acute Kawasaki disease treated in our hospital from August 2016 to August 2020 were selected and divided into dilation group(n=28)and non dilation group(n=107)according to whether coronary artery dilation occurred.The baseline data and RDW/ESR,Chemerin and IL-13 of the two groups were compared.The multivariate logistic regression equation was used to analyze the relevant influencing factors of coronary artery dilatation,and the levels of RDW/ESR,Chemerin and IL-13 of children with different therapeutic responsiveness to intravenous immunoglobulin were compared.The receiver operating characteristic curve(ROC curve)was used to analyze the value of each index and combined prediction of therapeutic responsiveness.【Results】RDW/ESR,Chemerin and IL-13 in the expansion group were higher than those in the non expansion group(P<0.05);Multiple logistic regression analysis showed that RDW/ESR,Chemerin and IL-13 were all related to coronary dilatation(P<0.05).The levels of Chemerin and IL-13 in treatment sensitive children were lower than those in non sensitive children(P<0.05).ROC curve showed that the AUC of the combination of Chemerin and IL-13 in predicting IVIG treatment response was higher than that predicted alone,and the AUC was 0.891.【Conclusion】RDW/ESR,Chemerin and IL-13 are all related to coronary artery dilatation in children with acute Kawasaki disease.Chemerin and IL-13 can effectively predict the therapeutic response of intravenous immunoglobulin,and provide basis for timely and effective individualized treatment.