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| 血浆前清蛋白对川崎病患儿冠状动脉病变的预测意义 |
| Significance of plasma prealbumin in predicting coronary artery disease in children with Kawasaki disease |
| 投稿时间：2019-12-02 |
| DOI：10.3969/j.issn.1000-0399.2020.04.008 |
| 中文关键词: 川崎病 冠状动脉病变 前清蛋白 |
| 英文关键词: Kawasaki disease Coronary artery lesion Prealbumin |
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| 中文摘要: |
| 目的 探讨血浆前清蛋白(PA)水平对川崎病(KD)患儿合并冠状动脉病变(CAL)的预测意义。方法 回顾性分析2014年1月至2018年12月安徽医科大学第一附属医院儿科收治的128例KD患儿(KD组)的临床资料和50例同期健康体检儿童(对照组)的体检资料。KD组根据临床特点分为典型KD组98例和不典型KD组30例,根据是否合并CAL分为CAL组23例和nCAL组105例,记录各组患者PA、中性粒细胞绝对值(NEUT)、血小板计数(PLT)、清蛋白(Alb)、谷丙转氨酶(ALT)、C反应蛋白(CRP)、血沉(ESR)及心脏多普勒超声心动图结果,对各组间以上指标进行相关性分析,并绘制受试者工作特征(ROC)曲线,得出PA的最佳截断值,计算PA判断KD合并CAL的敏感度和特异度。结果 治疗前KD组PA水平为(68.91±40.65)mg/L,低于对照组的(180.20±31.81)mg/L,差异有统计学意义(P<0.05);典型KD组PA水平(67.19±41.29)mg/L低于不典型KD组的(74.53±38.60)mg/L,但差异无统计学意义(P>0.05);CAL组PA水平(53.30±24.73)mg/L低于nCAL组的(72.33±42.69)mg/L,差异有统计学意义(P>0.05);根据ROC曲线,PA的截断值选为82.5 mg/L时,敏感度为87.0%,特异度为69.5%。结论 血浆PA水平有望作为KD患儿合并CAL的预测指标之一。 |
| 英文摘要: |
| Objective To investigate the significance of plasma prealbumin (PA) level in predicting coronary artery lesion(CAL) in Kawasaki disease(KD). Methods The clinical data of 128 children with KD was restrospectively analyzed from January 2014 to December 2018 in the First Affiliated Hospital of Anhui Medical University. According to clinical manifestations, 98 patients were divided into typical KD group, and 30 patients into atypical KD group. According to whether or not the combined coronary artery damage occurred, the patients were divided into 23 cases in CAL group and 105 cases in nCAL group. Another 50 children undergoing physical examination at the same time were selected as control group. The results of PA, neutrophil (NEUT), platelet (PLT), serum albumin (Alb), glutamic-pyruvic transaminase (ALT), C reactive protein (CRP), erythrocyte sedimentation rate (ESR) and cardiac Doppler echocardiography were recorded, and the correlations between the above indexes were then analyzed respectively. Receiver operating characteristics curve (ROC curve) for plasma PA level was built to evaluate the predictive value of PA levels on CAL in children with Kawasaki disease, and then the optimal cut-off point of PA levels was obtained. Diagnostic parameters such as sensitivity and specificity were also calculated for comparison. Results Before treatment, the level of PA in KD group(68.91±40.65) mg/L was significantly lower than that in control group (180.20±31.81) mg/L. The level of PA in typical KD group (67.19±41.29) mg/L was lower than that in atypical KD group (74.53±38.60) mg/L, but no significant difference was found between them (P>0.05). The level of PA in CAL group (53.30±24.73) mg/L was significantly lower than that in nCAL group (72.33±42.69) mg/L (P> 0.05). ROC curve showed that when the threshold value of PA level was 82.5mg/L, the sensitivity was 87.0%, and the specificity was 69.5%. Conclusion Plasma PA level is expected to be one of the predictors in KD with CAL. |
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