[1]黄君华,崔自明,张书婉,等.完全性川崎病患儿血清 25-羟基维生素 D水平检测对预测 IVIG抵抗的价值研究[J].现代检验医学杂志,2022,37(01):28-32.[doi:10.3969/j.issn.1671-7414.2022.01.006]
　HUANG Jun-hua,CUI Zi-ming,ZHANG Shu-wan,et al.Value of Serum 25-Hydroxyvitamin D Levels in the Prediction of Intravenous Immunoglobulin Resistance in Patients withComplete Kawasaki Disease[J].Journal of Modern Laboratory Medicine,2022,37(01):28-32.[doi:10.3969/j.issn.1671-7414.2022.01.006]
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完全性川崎病患儿血清 25-羟基维生素 D水平检测对预测 IVIG抵抗的价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年01期
页码:
28-32
栏目:
论　著
出版日期:
2022-01-15

文章信息/Info

Title:
Value of Serum 25-Hydroxyvitamin D Levels in the Prediction of Intravenous Immunoglobulin Resistance in Patients withComplete Kawasaki Disease
文章编号:
1671-7414（2022）01-028-05
作者:
黄君华1; 崔自明2; 张书婉3; 祝撷英3; 曹三成3
（1. 西安医学院医学技术学院，西安 710021；2. 解放军总医院京东医疗区光明桥门诊部，北京 100061；3. 西安市儿童医院检验科，西安 710003）
Author(s):
HUANG Jun-hua1;  CUI Zi-ming2;  ZHANG Shu-wan3;  ZHU Xie-ying3; CAO San-cheng3
（1.Department of Medical Technology, Xi’an Medical University, Xi’an 710021, China; 2.Department ofGuangmingqiao Outpatient Jingdong Medical District, Chinese PLA General Hospital, Beijing 100061, China;3. Department of Clinical Laboratory，Xi’an Children’s Hospital, Xi’an 710003, China）
关键词:
维生素 D; 川崎病; 静脉注射免疫球蛋白抵抗; 受试者工作特征曲线
分类号:
R725.5；R446.11
DOI:
10.3969/j.issn.1671-7414.2022.01.006
文献标志码:
A
摘要:
目的　探讨完全性川崎病（ complete Kawasaki disease, CKD）患儿血清 25-羟基维生素 D[25-hydroxyvitamin D, 25-(OH)D]预测静脉注射免疫球蛋白（ intravenous immunoglobulin, IVIG）抵抗的价值。方法　以 2018年全年在西安市儿童医院确诊为 CKD的患儿 105例为研究对象（其中 IVIG抵抗者 14例），绘制 25-(OH)D预测 IVIG抵抗的受试者工作特征曲线（ receiver operator characteristic curve，ROC），并确定截断值（ cut-o.值）；同期 45例健康儿童为对照。以 2019年全年的 CKD患者检验该 cut-o.值预测 IVIG抵抗的效能。所有研究对象血清 25-(OH)D浓度由电化学发光法测定。结果　健康对照组血清 25-(OH)D水平 [36.1（29.3~46.2）ng/ml]高于 CKD组 [25.2（18.9~33.1）ng/ml]，差异有统计学意义（Z=-4.823, P<0.001）；IVIG抵抗组 [18.1（16.4~21.8）ng/ml]低于 IVIG敏感组 [27.2（20.4~34.7）ng/ml]，差异有统计学意义（ Z=-3.700, P<0.001）；血清 25-(OH)D在 25.17 ng/ml时尤登指数最大（为 0.473），ROC曲线下面积 0.818。在实际应用中，以 25.17 ng/ml为 cut-o.值，血清 25-(OH)D预测 CKD-IVIG抵抗的敏感度、特异度、阳性预测值、阴性预测值、诊断准确度分别为 81.2%，62.1%，25.0%，95.5%和 64.7%。结论　血清 25-(OH)D的定量检测对 CKD患儿 IVIG抵抗有较好的预测作用；CKD患儿血清 25-(OH)D高于 25.17ng/ml时发生 IVIG抵抗的可能性较低。
Abstract:
Objective　To explore the value of serum 25-hydroxyvitamin D[25-(OH)D] levels in the prediction intravenousimmunoglobulin (IVIG) resistance in patients with complete Kawasaki disease (CKD). Methods　The total of 105 children withCKD hospitalized in Xi’an Children Hospital in 2018 were enrolled in this study to yield a receiver operating characteristic curve(ROC curve) and determine the cut-off value of 25-(OH)D concentration in predicting IVIG resistance. Meanwhile, 45 healthychildren were enrolled as control group. Then, evaluated the prediction efficiency of the cut-off value of serum 25-(OH)D forIVIG resistance in CKD population hospitalized in Xi’an Children Hospital in 2019. Electrochemiluminescence immunoassaywas applied to measure the serum levels of 25-(OH)D of the enrolled individuals. Results　The serum levels of 25-(OH)D werehigher in control children than in CKD patients [36.1 (29.3~46.2) ng/ml vs 25.2 (18.9~33.1) ng/ml], the difference wasstatistically significant (Z =-4.823, P<0.001), and serum 25-(OH)D levels of IVIG resistance group [18.1 (16.4~21.8) ng/ml]were significantly lower than that of non-IVIG resistance group [27.2 (20.4~34.7) ng/ml], the difference was statisticallysignificant (Z=-3.700, P<0.001). When the cut-off value of serum 25-(OH)D concentration was at 25.17 ng/ml, the area under theROC curve (AUC) was 0.818 with a largest Youden index (0.473). Moreover, the cut-off value of 25.17 ng/ml to predict IVIGresistance yielded a sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were81.2%, 62.1%, 25.0%, 95.5% and 64.7%, respectively. Conclusion　Serum 25-(OH)D levels have a contributiverole in the prediction of IVIG resistance in CKD. CKD patients with a serum 25-(OH)D concentration higher than 25.17 ng/mlmight not develop IVIG resistance.

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备注/Memo

备注/Memo:
基金项目：陕西省自然科学基础研究计划项目（2020JQ-884）；西安市儿童医院院级课题扶持项目（2019C10）。
作者简介：黄君华（1985-），男，硕士，讲师，研究方向：川崎病发病机制及临床诊断，E-mail：huangjunhua1985@163.com。
通讯作者：曹三成，主任技师，西安市儿童医院检验科主任，E-mail：jianyan2080@163.com。
更新日期/Last Update: 1900-01-01