[1]李月悦a,唐 莉a,朱明跃b.川崎病患儿血清CTRP9 和sCD146 水平表达与冠状动脉损伤的相关性研究[J].现代检验医学杂志,2024,39(03):170-175.[doi:10.3969/j.issn.1671-7414.2024.03.029]
　LI Yueyuea,TANG Lia,ZHU Mingyueb.Correlation between the Expression Levels of Serum CTRP9 and sCD146 and Coronary Artery Lesions in Children with Kawasaki Disease[J].Journal of Modern Laboratory Medicine,2024,39(03):170-175.[doi:10.3969/j.issn.1671-7414.2024.03.029]
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川崎病患儿血清CTRP9 和sCD146 水平表达与冠状动脉损伤的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年03期
页码:
170-175
栏目:
论著
出版日期:
2024-05-15

文章信息/Info

Title:
Correlation between the Expression Levels of Serum CTRP9 and sCD146 and Coronary Artery Lesions in Children with Kawasaki Disease
文章编号:
1671-7414（2024）03-170-06
作者:
李月悦a; 唐 莉a; 朱明跃b
（重庆市开州区人民医院a. 内科；b. 儿科，重庆 405400）
Author(s):
LI Yueyuea; TANG Lia; ZHU Mingyueb
（a. Department of Internal Medicine；b. Department of Pediatrics， the People’s Hospital of Kaizhou District，CQ，Chongqing 405400，China）
关键词:
川崎病; C1q/TNF 相关蛋白9; 可溶性CD146; 冠状动脉损伤
分类号:
R725.4；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.03.029
文献标志码:
A
摘要:
目的 探究川崎病（Kawasaki disease，KD）患儿血清C1q /TNF 相关蛋白9（C1q/tumor necrosis factor relatedprotein 9，CTRP9）和可溶性CD146（soluble CD146，sCD146）水平与冠状动脉损伤（coronary artery lesion，CAL）的相关性。方法 选取重庆市开州区人民医院2020 年10 月～ 2023 年2 月收治的116 例KD 患儿为研究对象（KD 组），根据超声诊断结果将KD 患儿分为CAL 组（n=40）和非CAL 组（n=76）；另根据CAL 严重程度将CAL 组KD 患儿分为轻度组（n=14）、中度组（n=18）和重度组（n=8）。酶联免疫吸附法（ELISA）测定血清CTRP9 和sCD146 水平；比较对照组、CAL 组、非CAL 组及不同CAL 严重程度患儿血清CTRP9，sCD146 水平；多元Logistic 回归分析影响KD 患儿出现CAL 的因素；ROC 曲线分析血清CTRP9，sCD146 水平对KD 患儿出现CAL 的预测价值。结果 与对照组比较，KD 组血清CTRP9 水平降低（3.27±0.27ng/ml vs 3.79±0.91ng/ml），sCD146 水平升高（191.28±50.39 ng/mlvs 143.97±38.29 ng/ml），差异具有统计学意义（t=5.900，8.051，均P ＜ 0.05）。CAL 组患儿血清CTRP9 水平低于非CAL 组（3.01±0.23ng/ml vs 3.41±0.29 ng/ml），sCD146 水平高于非CAL 组（232.18±59.37 ng/ml vs 169.76±45.66ng/ml），差异具有统计学意义（t=7.557，6.294，均P ＜ 0.05）。与轻度组比较，中度组、重度组患儿血清CTRP9 水平降低（q =3.277，6.281），血清sCD146 水平升高（q=3.154，3.551），且重度组患儿血清CTRP9水平低于中度组（q=3.845），血清sCD146 水平高于中度组（q=3.145），差异均具有统计学意义（均P ＜ 0.05）。多因素Logistic 回归分析结果显示，白细胞计数（white blood cell count，WBC）、红细胞沉降率（erythrocyte sedimentation rate，ESR）、C 反应蛋白（Creactive protein，CRP）、CTRP9 和sCD146 均是影响KD 患儿发生CAL 的影响因素（均P ＜ 0.05）。ROC 曲线结果显示，CTRP9，sCD146 单独预测KD 患儿发生CAL 的AUC 分别为0.781，0.782，敏感度分别为82.5%，67.5%，特异度分别为52.2%，55.7%，两者联合诊断KD 患儿发生CAL 的AUC 为0.889，敏感度和特异度分别为97.5%，65.9%。结论 血清CTRP9，sCD146 为KD 患儿发生CAL 的影响因素，且CTRP9 水平在CAL 患儿血清中水平降低，sCD146水平升高，两者联合可有效预测KD 患儿CAL 的发生。
Abstract:
Objective To investigate the correlation between serum C1q/tumor necrosis factor related protein 9 (CTRP9) and soluble CD146 (sCD146) levels and coronary artery lesions (CAL) in children with Kawasaki disease (KD). Methods A total of 116 children with KD admitted to the People’s Hospital of Kaizhou District, CQ from October 2020 to February 2023 were selected as the study subjects (KD group). According to the ultrasound diagnosis results, children with KD were grouped into CAL group (n=40) and non CAL group (n=76). According to the severity of CAL, children with KD in the CAL group were separated into mild group (n=14), moderate group (n=18) and severe group (n=8). Enzyme linked immunosorbent assay (ELISA) was applied to measure serum levels of CTRP9 and sCD146. The differences in serum levels of CTRP9 and sCD146 in control group, CAL group, non CAL, and children with different severity of CAL were compared. Multiple Logistic regression was applied to analyze the factors affecting the occurrence of CAL in children with KD. Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum CTRP9 and sCD146 levels for the occurrence of CAL in KD children. Results Compared with the control group, the serum CTRP9 level in the KD group was decreased（3.27±0.27ng/ml vs 3.79±0.91ng/ml）, while the sCD146 level was increased（191.28±50.39 ng/ml vs 143.97±38.29 ng/ml）, with significant differences (t=5.900, 8.051, all P<0.05). The serum CTRP9 level in the CAL group was lower than that in the non CAL group （3.01±0.23ng/ml vs 3.41±0.29 ng/ml）, but the sCD146 level was higher than that in the non CAL group（232.18±59.37 ng/ml vs 169.76±45.66 ng/ml）, with significant differences (t=7.557, 6.294, all P<0.05). Compared with the mild group, the serum CTRP9 level in the moderate and severe groups was decreased (q=3.277, 6.281), with sCD146 level increased (q = 3.154, 5.551) , the serum CTRP9 level in the severe group was lower than that in the moderate group (q=3.845), with sCD146 level was higher than that in the moderate group（q=3.145）, and the differences were statistically significant (all P<0.05). The results of multivariate logistic regression analysis showed that white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), CTRP9 and sCD146 were all influencing factors for the occurrence of CAL in children with KD (all P<0.05). The results of ROC curve showed that the AUCs of CTRP9 and sCD146 separately predicted the occurrence of CAL in KD children were 0.781 and 0.782, with sensitivity of 82.5% and 67.5%, and specificity of 52.2% and 55.7%, respectively. The AUC for the combined diagnosis of CAL in children with KD was 0.889, with sensitivity and specificity of 97.5% and 65.9%, respectively. Conclusion Serum CTRP9 and sCD146 were influencing factors for the occurrence of CAL in children with KD, and the level of CTRP9 was decreased, while sCD146 was increased in the serum of children with CAL. The combination of the two can effectively predict the occurrence of CAL in children with KD.

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备注/Memo

备注/Memo:
作者简介：李月悦（1991-），女，本科，主治医师，研究方向：儿童心血管内科，E-mail：zwrvro@163.com。
通讯作者：唐莉（1982-），女，本科，副主任医师，研究方向：儿童呼吸内科，E-mail：lingpah474@163.com。
更新日期/Last Update: 2024-05-15