[1]严晓华,万璐,高娜,等.川崎病冠脉病变患者血清穿孔素与和肽素检测的早期诊断及对清热益气活血法治疗预后的价值评价[J].现代检验医学杂志,2026,41(05):14-19.[doi:10.3969/j.issn.1671-7414.2026.05.003]
　YAN Xiaohua,WAN Lu,GAO Na,et al.Evaluation of the Value of Serum Perforin and Copeptin Detection in Early Diagnosis of Kawasaki Disease with CoronaryArtery Lesions and in Evaluation of Prognosis Following Qingre Yiqi Huoxue Therapy[J].Journal of Modern Laboratory Medicine,2026,41(05):14-19.[doi:10.3969/j.issn.1671-7414.2026.05.003]
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川崎病冠脉病变患者血清穿孔素与和肽素检测的早期诊断及对清热益气活血法治疗预后的价值评价()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第41卷
期数:
2026年05期
页码:
14-19
栏目:
论著
出版日期:
2026-09-15

文章信息/Info

Title:
Evaluation of the Value of Serum Perforin and Copeptin Detection in Early Diagnosis of Kawasaki Disease with CoronaryArtery Lesions and in Evaluation of Prognosis Following Qingre Yiqi Huoxue Therapy
文章编号:
1671-7414 （2026） 05-014-06
作者:
严晓华1a，万璐2，高娜1a，穆志龙1a，贺望1a，万萱1a，马娟1b
（1.陕西省人民医院a.儿童病院；b.检验科，西安710068；2．西安市中医医院儿科，西安710021）
Author(s):
YAN Xiaohua1a, WAN Lu2, GAO Na1a, MU Zhilong1a, HE Wang1a, WAN Xuan1a, MA Juan1b
(1a. Children’s Hospital; 1b. Department of Laboratory, Shaanxi Provincial People’s Hospital, Xi’an 710068, China; 2. Department of Pediatrics, Xi’an Hospital of Traditional Chinese Medicine, Xi’an 710021, China)
关键词:
川崎病;  冠状动脉病变;  穿孔素;  和肽素;  清热益气活血方
分类号:
R725.9； R446.6
DOI:
10.3969/j.issn.1671-7414.2026.05.003
文献标志码:
A
摘要:
目的 探讨川崎病冠状动脉病变 （KD-CAL） 患者血清穿孔素与和肽素检测的早期诊断价值， 分析两者对清热益 气活血法治疗预后的价值。 方法 选择2021年7月~2023年7月陕西省人民医院收治的120例KD患儿作为研究对象； 采 用彩色多普勒超声诊断仪检测冠脉内径并计算Z值， 根据Z值将KD患儿分为KD无冠脉病变组 （KD-nonCAL组， Z<2.5） 和KD冠脉病变组 （KD-CAL组， Z≥2.5） ， 每组60例。 所有患儿均采用清热益气活血方联合西药 （IVIG+阿司匹林+双嘧达 莫） 的治疗方案， 治疗4周后开展疗效评价， 比较治疗前及治疗4周后外周血穿孔素、 和肽素、 炎性指标 （IL-17A、 TNF-α、 PCT、 CRP、 ESR） 和血常规指标 （WBC、 PLT、 HCT） 。 结果 与KD-nonCAL组比较， KD-CAL组的穿孔素、 和肽素水平升 高， 炎性指标 （IL-17A、 TNF-α、 PCT、 CRP、 ESR） 、 血常规指标 （WBC和PLT）升高， HCT降低， 差异具有统计学意义 （t= -16.963~4.625， 均P<0.05） ；相关性分析显示， Z值与KD患儿的穿孔素和和肽素水平显著正相关 （r=0.646、 0.621， 均 P<0.05） ； 穿孔素、 和肽素及二者联合诊断KD-CAL的ROC曲线下面积 （AUC） 分别为0.975、 0.942和0.989。 经清热益气活 血方联合西药治疗4周后， 共有显效67例， 有效43例， 无效10例， 总有效率为91.67%； 与显效+有效组比较， 无效组的Z 值、 穿孔素、 和肽素升高 （t=-12.990、 -16.902、 -19.006， 均P<0.05） 。 多元线性回归分析显示， 治疗前后的和肽素 （B=0.043、 Beta=0.300， t=3.013、 P=0.003） 、 穿孔素 （B=0.004、 Beta=0.282， t=2.779、 P=0.006） 、 CRP （B=0.011、 Beta=0.205， t=2.134、 P=0.035） 差值均与Z值差值呈显著正相关。 结论 穿孔素联合和肽素对KD-CAL具有较高诊断价值， 同时和肽素、 穿孔素、 CRP是预 测KD患儿清热益气活血法治疗后冠脉病变改善情况的重要因素。
Abstract:
Objective To investigate the value of serum perforin and copeptin detection in the early diagnosis of Kawasaki disease with coronary artery lesions (KD-CAL), and to analyze the value of the two indicators in evaluating the prognosis of patients treated with Qingre Yiqi Huoxue Therapy. Methods A total of 120 children with Kawasaki Disease (KD) admitted to Shaanxi Provincial People’s Hospital from July 2021 to July 2023 were enrolled. Coronary artery diameter was measured by color Doppler echocardiography, and Z-scores were calculated. According to Z-score, the children with KD were divided into two groups: a KD group without coronary artery lesions (KD-nonCAL group, Z<2.5, n= 60) and a KD group with coronary artery lesions (KD-CAL group, Z ≥ 2.5, n=60). All children received the treatment regimen of Qingre Yiqi Huoxue Decoction combined with Western medicine (IVIG, aspirin, and dipyridamole). Efficacy evaluation was conducted after 4 weeks of treatment. Serum levels of perforin, copeptin, in?ammatory indicators (IL-17A, TNF-α, PCT, CRP, ESR), and routine blood test indicators (WBC, PLT, HCT) were compared before treatment and 4 weeks after treatment. Results Compared with the KD- nonCAL group, the KD-CAL group showed signi?cantly elevated levels of perforin, copeptin, in?ammatory indexes (IL-17A, TNF-α, PCT, CRP, ESR), and routine blood test indexes (WBC, PLT), as well as signi?cantly decreased HCT (t=-16.963 to 4.625, all P<0.05). Correlation analysis showed that Z-score was signi?cantly positively correlated with the levels of perforin and copeptin (r=0.646 and 0.621, both P<0.05). The areas under the ROC curve (AUC) of perforin, copeptin, and their combination for diagnosing KD-CAL were 0.975, 0.942, and 0.989, respectively. After 4 weeks of treatment with Qingre Yiqi Huoxue recipe combined with Western medicine, 67 patients showed marked improvement, 43 showed moderate improvement, and 10 showed no improvement, yielding a total response rate of 91.67%. Compared with the improved groups (marked + moderate), the non-improved group had significantly higher Z-scores, perforin, and copeptin levels (t=-12.990, -16.902, and -19.006, respectively, all P< 0.05). Multiple linear regression analysis showed that the pre-to-post treatment differences in copeptin (B=0.043, Beta = 0.300, t=3.013, P= 0.003), perforin (B=0.004, Beta=0.282, t=2.779, P=0.006), and CRP (B=0.011, Beta=0.205, t=2.134, P= 0.035) were all signi?cantly positively correlated with the change in Z-score. Conclusions Perforin combined with copeptin has high value in the early diagnosis of KD-CAL, and copeptin, perforin, and CRP are important factors for predicting the improvement of coronary artery lesions in children with KD following Qingre Yiqi Huoxue treatment.

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备注/Memo

备注/Memo:
基金项目： 陕西省中医药管理局科研课题（2021-01-ZZ-014）；陕西省中西医结合心血管病防治重点实验开放课题（2022XXG-YB-003）；陕西
作者简介：严晓华（1981-），女，博士，主任医师，研究方向：儿童川崎病、肾病、风湿免疫疾病，E-mail：Yxiaoh_chd@163.com。
通讯作者：马娟（1981-），女，硕士，主治医师，研究方向：临床微生物学，E-mail：majuanjuan2024@163.com。
更新日期/Last Update: 2026-09-15