血清PTX3、GDF-15、IL-17在川崎病患儿中的表达及与冠脉损伤的关系

Expression of Serum GDF-15, PTX3 and IL-17 in Children with Kawasaki Disease and Their Relationship with Coronary Artery Injury

目的 探讨血清生长分化因子-15(GDF-15)、正五聚蛋白3(PTX3)、白细胞介素-17(IL-17)在川崎病(KD)患儿中的表达及与冠脉损伤的关系。方法 回顾性分析2020年5月至2023年5月郑州大学附属郑州中心医院收治的114例KD患儿为研究对象,根据冠脉损伤情况分为损伤组(48例)和无损伤组(66例),另选取同时期114例健康体检儿童为对照组;根据冠状动脉内径将冠脉损伤患儿分为轻度扩张(21例)、中度扩张(18例)、冠状动脉瘤(9例)3个亚组。比较3组不同冠状动脉扩张程度患儿入院时血清GDF-15、PTX3、IL-17水平,分析入院时血清GDF-15、PTX3、IL-17水平与冠脉损伤及冠状动脉内径的相关性,偏回归分析KD患儿发生冠脉损伤的危险因素,受试者工作特征曲线(ROC)分析入院时血清IL-17、PTX3、GDF-15水平联合诊断KD患儿发生冠脉损伤的价值。结果 损伤组入院时血清GDF-15、PTX3、IL-17水平>无损伤组>对照组(P<0.05)。不同冠状动脉扩张程度患儿入院时血清IL-17、PTX3、GDF-15水平比较:冠状动脉瘤>中度扩张>轻度扩张(P<0.05)。相关性分析显示,入院时血清GDF-15、PTX3、IL-17水平与冠脉损伤、冠状动脉内径呈正相关(P<0.05)。logistic回归分析显示,入院时血清IL-17、PTX3、GDF-15水平为KD患儿发生冠脉损伤的危险因素(P<0.05)。ROC曲线分析显示,入院时血清GDF-15、PTX3、IL-17水平联合诊断KD患儿发生冠脉损伤的曲线下面积(AUC)为0.818,最佳诊断敏感度为93.75%,特异度为69.70%,高于各指标单独诊断(P<0.05)。结论 GDF-15、PTX3、IL-17参与KD患儿发生冠脉损伤过程,且在辅助临床早期诊断KD患儿发生冠脉损伤方面具有较高效能。

Objective To investigate the expression of serum growth differentiation factor-15(GDF-15),pentaprotein 3(PTX3)and interleukin-17(IL-17)in children with Kawasaki disease(KD)and their relationship with coronary artery injury.Methods A total of 114 children with KD admitted to Zhengzhou University Affiliated Zhengzhou Central Hospital from May 2020 to May 2023 were selected as the study objects,and were divided into injury group(48 cases)and non-injury group(66 cases)according to the status of coronary artery injury,and 114 healthy children during the same period were selected as the control group.According to the internal diameter of the coronary artery,the children with coronary artery injury were divided into three subgroups:mild dilation(21 cases),moderate dilation(18 cases)and coronary aneurysm(9 cases).The serum levels of GDF-15,PTX3 and IL-17 were compared between the three groups and children with different degrees of coronary artery dilation at admission,and the correlation between the serum levels of GDF-15,PTX3 and IL-17 and coronary artery injury and internal diameter at admission was analyzed,and the risk factors of coronary artery injury in children with KD were analyzed by partial regression.The value of subject’s work characteristic curve(ROC)analysis of serum IL-17,PTX3,and GDF-15 levels at admission for the combined diagnosis of coronary artery injury occurring in children with KD.Results Serum GDF-15,PTX3,and IL-17 levels at admission in the injury group>no injury group>control group(P<0.05).Comparison of serum IL-17,PTX3,and GDF-15 levels at admission in children with different degrees of coronary artery dilatation:coronary artery aneurysm>moderate dilatation>mild dilatation(P<0.05).Correlation analysis showed that serum GDF-15,PTX3,and IL-17 levels at admission were positively correlated with coronary artery injury and coronary artery internal diameter(P<0.05).logistic regression analysis showed that serum IL-17,PTX3,and GDF-15 levels at admission were the risk factors for coronary artery injury in children with KD(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the patients with KD diagnosed with serum GDF-15,PTX3 and IL-17 combined at admission was 0.818,the best diagnostic sensitivity was 93.75%,and the specificity was 69.70%,which was higher than that diagnosed by each index alone(P<0.05).Conclusion GDF-15,PTX3 and IL-17 are involved in the process of coronary artery injury in children with KD,and have high efficacy in assisting the early diagnosis of coronary artery injury in children with KD.