摘要
目的 探讨川崎病(Kawasaki disease, KD)并发冠状动脉损伤患儿血清基质金属蛋白酶-9(MMP-9)、组织型纤溶酶原激活物抑制物-1(PAI-1)、C反应蛋白(CRP)水平变化及临床意义。方法 选取2018年5月至2023年5月郑州大学附属郑州中心医院收治的86例KD患儿为观察组,同期86例健康体检儿童为对照组,根据是否并发冠状动脉损伤分为冠状动脉损伤(31例)和冠状动脉正常(55例)2个亚组。比较两组、冠状动脉损伤和冠状动脉正常KD患儿入院时血清MMP-9、PAI-1、CRP水平,偏回归分析KD并发冠状动脉损伤的危险因素,ROC分析入院时血清MMP-9、PAI-1、CRP水平联合检测对KD并发冠状动脉损伤的诊断价值,各指标不同水平KD患儿并发冠状动脉损伤的危险度。结果 观察组入院时血清MMP-9、PAI-1、CRP水平高于对照组(P<0.05);冠状动脉损伤患儿入院时血清MMP-9、PAI-1、CRP水平高于冠状动脉正常患儿(P<0.05);logistic回归分析显示,入院时血清MMP-9、PAI-1、CRP水平为KD患儿并发冠状动脉损伤的危险因素(P<0.05);ROC曲线分析显示,入院时血清MMP-9、PAI-1、CRP水平联合诊断KD并发冠状动脉损伤的AUC为0.823,最佳诊断敏感度为93.55%,特异度为70.91%,高于单一指标诊断(P<0.05);危险度分析显示,入院时血清MMP-9、PAI-1、CRP高水平KD患儿并发冠状动脉损伤危险度是低水平的3.726、2.781、2.422倍(P<0.05)。结论 血清MMP-9、PAI-1、CRP水平与KD并发冠状动脉损伤显著相关,且在辅助临床早期诊断KD并发冠状动脉损伤方面具有较高效能。
Objective To investigate the changes of serum matrix metalloproteinase-9(MMP-9), tissue plasminogen activator inhibitor 1(PAI-1) and C-reactive protein(CRP) levels and their clinical significance in children with Kawasaki disease(KD) complicated with coronary artery injury.Methods A total of 86 KD children admitted to our hospital from May 2018 to May 2023 were selected as the observation group, and 86 healthy children during the same period were selected as the control group. They were divided into two subgroups according to whether there was concurrent coronary artery injury(31 cases) and normal coronary artery(55 cases). The serum levels of MMP-9, PAI-1 and CRP were compared between the two groups, the children with coronary artery injury and the children with normal coronary artery KD at admission, the risk factors of KD complicated with coronary artery injury were analyzed by partial regression, and the diagnostic value of combined detection of serum MMP-9, PAI-1 and CRP at admission was analyzed by ROC. The risk of coronary artery injury in children with different KD levels.Results The serum levels of MMP-9, PAI-1 and CRP in observation group were higher than those in control group at admission(P<0.05). The serum levels of MMP-9, PAI-1 and CRP in children with coronary artery injury were higher than those in children with normal coronary artery(P<0.05). Logistic regression analysis showed that serum MMP-9, PAI-1 and CRP levels were risk factors for coronary artery injury in KD children at admission(P<0.05). ROC curve analysis showed that the AUC of serum MMP-9, PAI-1 and CRP in the diagnosis of KD complicated with coronary artery injury at admission was 0.823, the best diagnostic sensitivity was 93.55%, and the specificity was 70.91%, which was higher than that of single index diagnosis(P<0.05). Risk analysis showed that the risk of coronary artery injury in children with KD with high serum MMP-9, PAI-1 and CRP at admission was 3.726, 2.781 and 2.422 times of that with low serum MMP-9, PAI-1 and CRP at admission(P<0.05).Conclusion Serum MMP-9, PAI-1 and CRP levels are significantly correlated with KD complicated with coronary artery injury, which have high efficacy in assisting the early diagnosis of KD complicated with coronary artery injury.
作者
张嘉雯
ZHANG Jia-wen(Department of Pediatrics,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)
出处
《医药论坛杂志》
2024年第6期624-628,共5页
Journal of Medical Forum
