川崎病患儿血清总胆汁酸和心肌酶谱变化及其与冠状动脉损伤的相关性分析

Changes in serum total bile acid and myocardial enzymes in children with Kawasaki disease and their correlation with coronary artery lesion

目的:对川崎病(KD)患儿血清总胆汁酸(TBA)和心肌酶谱变化及其与冠状动脉损伤的相关性分析。方法:选择2022年7月至2024年6月上饶市妇幼保健院确诊为KD的60例患儿作为观察组,根据是否出现冠状动脉损伤(CAL)分为NCAL组(30例)和CAL组(30例),选择60例体检健康的儿童作为对照组。采集两组儿童的血液标本,测定心肌酶谱[谷氨酸氨基转移酶、乳酸脱氢酶、肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、α-羟丁酸脱氢酶(HBDH)]和TBA的水平。Logistic回归分析KD患儿TBA和心肌酶谱变化与CAL的相关性。结果:观察组CK、CK-MB、TBA、HBDH水平高于对照组(P<0.05);急性期KD患儿的CK、CK-MB、TBA、HBDH水平高于恢复期的KD患儿(P<0.05);CAL组的CK、CK-MB、TBA、HBDH水平高于NCAL组(P<0.05);Logistic回归分析显示CK、CK-MB、TBA、HBDH水平的升高与CAL的发生具有相关性(P<0.05)。结论:KD患儿CK、CK-MB、TBA水平升高是KD患儿并发CAL的危险因素,早期对患儿进行TBA和心肌酶谱检测对预测CAL具有较高的应用价值。

Objective:To analyze the changes in serum total bile acid(TBA)and myocardial enzymes in children with Kawasaki disease(KD),and their correlation with coronary artery lesion(CAL).Methods:Sixty children who were diagnosed with KD at Shangrao Maternal and Child Healthcare Hospital from July 2022 to June 2024 were selected as the observation group.According to the presence or absence of CAL,they were divided into NCAL group(30 cases)and CAL group(30 cases).Meanwhile,60 healthy children were selected as the control group.Blood samples were collected from the two groups to measure the levels of myocardial enzymes[aspartate transaminase(AST),lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase-MB(CK-MB)and alpha-hydroxybutyrate dehydrogenase(HBDH)],and TBA.The correlation between changes of TBA and myocardial enzymes and CAL in children with KD was discussed.Results:The levels of CK,CK-MB,TBA and HBDH in the observation group were higher than those in the control group(P<0.05).The levels of CK,CK-MB,TBAand HBDH in children with KD in acute phase were higher than those in recovery phase(P<0.05).The levels of CK,CK-MB,TBA and HBDH in the CAL group were higher than those in the NCAL group(P<0.05).Logistic regression analysis found that elevated levels of CK,CK-MB,TBA and HBDH were correlated with the occurrence of CAL(P<0.05).Conclusion:CK,CK-MB,and TBA are influencing factors of CAL in children with KD.Early detection of TBA and myocardial enzymes in children with KD is of high practical value in predicting CAL.