NF-κB PAI-1 血沉在川崎病并发冠状动脉损伤诊断及病情评估中的应用价值

doi:10.3969/j.issn.1006-6233.2022.04.013

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摘要 目的:探究核因子κB(NF-κB)、组织型纤溶酶原激活物抑制物-1(PAI-1)、血沉(ESR)在川崎病并发冠状动脉损伤诊断及病情评估中的应用价值。方法:选取2017年5月至2021年4月我院245例川崎病患儿作为研究对象,根据冠状动脉超声检查结果分为观察组(并发冠状动脉损伤,n=42)与对照组(未并发冠状动脉损伤,n=203)。比较两组临床资料、NF-κB、PAI-1、ESR水平,分析川崎病并发冠状动脉损伤发病影响因素,绘制受试者工作(ROC)曲线,评价NF-κB、PAI-1、ESR水平对川崎病并发冠状动脉损伤的诊断价值,比较不同冠状动脉扩张程度患儿NF-κB、PAI-1、ESR水平,分析NF-κB、PAI-1、ESR水平与冠状动脉扩张程度的关系。结果:观察组男性比例、血小板计数、静脉注射用免疫球蛋白始用时间、发热持续时间、NF-κB、PAI-1、ESR水平均高于对照组(P<0.05);Logistic回归分析,结果显示男性、血小板计数、静脉注射用免疫球蛋白始用时间、发热持续时间、NF-κB、PAI-1、ESR水平均为川崎病并发冠状动脉损伤发病独立影响因素(P<0.05);以川崎病并发冠状动脉损伤为阳性样本,未并发冠状动脉损伤为阴性样本,绘制NF-κB、PAI-1、ESR水平对川崎病并发冠状动脉损伤的诊断价值的ROC曲线,结果显示NF-κB、PAI-1、ESR水平对川崎病并发冠状动脉损伤的诊断价值的AUC分别为0.814、0.656、0.726,应用Logistic二元回归拟合,构建各指标联合诊断的AUC,结果显示,各指标联合的AUC为0.882;随着冠状动脉扩张程度增加,患儿NF-κB、PAI-1、ESR水平明显升高,且差异有统计学意义(P<0.05);川崎病并发冠状动脉损伤患儿NF-κB、PAI-1、ESR水平与冠状动脉扩张程度呈正相关关系(P<0.05)。结论:川崎病并发冠状动脉损伤患儿NF-κB、PAI-1、ESR水平明显升高,且与冠状动脉扩张程度呈正相关关系,临床检测其水平,有助于疾病早期诊断及病情评估,为临床诊疗提供依据。

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	王智海

关键词 ：川崎病, 冠状动脉损伤, 核因子κB, 组织型纤溶酶原激活物抑制物-1, 血沉

Abstract：Objective: To explore the application of nuclear factor kappa B (NF-κB), tissue-type plasminogen activator inhibitor-1 (PAI-1), and erythrocyte sedimentation rate (ESR) in the diagnosis and evaluation of coronary artery injury complicated by Kawasaki disease. Methods: A total of 245 children with Kawasaki disease in our hospital from May 2017 to April 2021 were selected as the research subjects. According to the results of coronary ultrasound examination, they were divided into observation group (complicated by coronary artery injury, n=42) and control group (without coronary artery injury, n=203). The clinical data, NF-κB, PAI-1, and ESR levels of the two groups were compared, the factors affecting the incidence of Kawasaki disease complicated by coronary artery injury were analyzed, the receiver operating curve (ROC) was plotted, and the level of NF-κB, PAI-1, and ESR was evaluated. And then the levels of NF-κB, PAI-1 and ESR in children with different degrees of coronary artery dilation were compared, and the relationship between the levels of NF-κB, PAI-1, ESR and the degree of coronary artery dilation was analyzed. Results: The proportion of male in the observation group, platelet count, starting time of intravenous immunoglobulin, duration of fever, NF-κB, PAI-1, and ESR levels were higher than those in the control group (P<0.05); Logistic regression analysis showed that male, platelet count, starting time of intravenous immunoglobulin, duration of fever, NF-κB, PAI-1, and ESR levels are all independent factors influencing the onset of Kawasaki disease complicated by coronary artery injury (P<0.05); Kawasaki disease complicated by coronary artery injury is a positive sample, and non-complicated coronary artery injury is a negative sample. The ROC curve of the diagnostic value of NF-κB, PAI-1, and ESR levels to Kawasaki disease complicated by coronary artery injury was plotted. The results showed that the AUCs of the diagnostic value of NF-κB, PAI- 1, ESR level for Kawasaki disease complicated by coronary artery injury were 0.814, 0.656, 0.726, respectively. Logistic binary regression fitting was used to construct the AUC of each index combined diagnosis. The results showed that the combined AUC of each index was 0.882 . With the increase of coronary artery dilation, the levels of NF-κB, PAI-1, and ESR in children increased significantly, and the difference was statistically significant (P<0.05). There is a positive correlation between the levels of NF-κB, PAI and ESR in children with Kawasaki disease complicated by coronary artery injury and the degree of coronary artery dilation (P<0.05). Conclusion: The levels of NF-κB, PAI-1 and ESR in children with Kawasaki disease complicated by coronary artery injury are significantly increased, and are positively correlated with the degree of coronary artery dilation. Clinical detection of their levels is helpful for early diagnosis and evaluation of the disease. It provides clinical basis for diagnosis and treatment.

Key words： Kawasaki disease Coronary artery injury NF-κB PAI-1 ESR

基金资助:云南省卫生健康委临床医学课题,(编号:ZX201712321)

引用本文:

王智海. NF-κB PAI-1 血沉在川崎病并发冠状动脉损伤诊断及病情评估中的应用价值[J]. 河北医学, 2022, 28(4): 594-598.
WANG Zhihai. The Application Value of NF-κB PAI-1 and Erythrocyte Sedimentation Rate in Diagnosis and Evaluation of Coronary Artery Injury Complicated by Kawasaki Disease. HeBei Med, 2022, 28(4): 594-598.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.04.013 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I4/594

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