可溶性肿瘤发生抑制蛋白2和白细胞介素33联合检测在川崎病患儿心血管受损早期诊断中的应用
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(1.湖南省人民医院 湖南师范大学第一附属医院检验科 急危重症代谢组学湖南省重点实验室, 湖南省长沙市 410005;2.湖南师范大学医学院,湖南省长沙市 410013)

作者简介:

彭剑桥,硕士,主管技师,研究方向为临床检验,E-mail为87513873@qq.com。通信作者叶湘漓,博士,教授,研究方向为心脏发育的基因调控,E-mail为ye_xiangli@qq.com。

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国家自然科学基金项目(81270291);国家留学基金(201708430158);湖南师范大学博士科研启动项目;急危重症代谢组学湖南省重点实验室开放课题基金(2017TP1034)


Application of combined detection of soluble suppression of tumorigenicity 2 and interleukin-33 in early diagnosis of cardiovascular impairment in children with Kawasaki's disease
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1.Department of Clinical Laboratory, Key Laboratory of Metabonomics of Critical Patients, Hunan Provincial People's Hospital & the First Affiliated Hospital of Hunan Normal University, Changsha, Hunan 410005, China;2.College of Medicine, Hunan Normal University, Changsha, Hunan 410013, China)

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    摘要:

    目的 评估可溶性肿瘤发生抑制蛋白2(sST2)及白细胞介素33(IL-33)在川崎病(KD)患儿心血管受损中的应用价值。方法 选择湖南省人民医院儿科2013年12月至2017年1月入院的282例KD患儿,其中心血管受累组35例,心血管未受累组247例,另外随机选取50例健康儿童作为对照组。分别检测3组儿童的sST2和IL-33血浆水平,分析KD患儿冠状动脉受损时sST2、IL-33和常规炎性指标C-反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞计数(WBC)的变化及相关性,对数据进行统计学分析。结果 心血管受累组的sST2和IL-33血浆水平明显高于心血管未受累组和对照组(P<0.05)。心血管受累组、心血管未受累组CRP、ESR和WBC显著高于对照组(P<0.05),但心血管受累组、心血管未受累组之间CRP、ESR和WBC差异无统计学意义(P>0.05)。静脉注射免疫球蛋白治疗后,心血管受累组sST2、IL-33水平明显下降(P<0.05),而心血管未受累组sST2、IL-33水平无明显变化(P>0.05)。Pearson相关分析显示,KD患儿的sST2、IL-33水平均与超声心动图Z值呈正相关。Logistic回归分析显示,sST2、IL-33均为KD患儿心血管损伤的独立危险因素(P<0.05)。ROC曲线分析显示,sST2、IL-33对KD心血管受损的预测具有较高的诊断价值。结论 KD患儿sST2、IL-33血浆水平与心血管受损的程度相关,对sST2和IL-33水平进行分析有助于评估KD患儿的心血管损伤程度及判断预后。

    Abstract:

    Aim To evaluate the value of soluble suppression of tumorigenicity 2 (sST2) and interleukin 33 (IL-33) in cardiovascular impairment in children with Kawasaki's disease (KD). Methods A total of 282 children with KD admitted to the Department of Pediatrics of Hunan Provincial People's Hospital from December 2013 to January 2017 were selected, including cardiovascular involvement group (n=35) and cardiovascular uninvolved group (n=247), and 50 healthy children were as control group. The levels of plasma sST2 and IL-33 were detected in 3 groups of children.Changes and correlations of sST2, IL-33 and conventional inflammatory markers C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) were analyzed in KD children with coronary artery lesion. Statistical methods were used to analyze data. Results The levels of plasma sST2 and IL-33 in the cardiovascular involvement group were significantly higher than those in the cardiovascular uninvolved group and the control group (P<0.05). CRP, ESR and WBC in cardiovascular involvement group and cardiovascular uninvolved group were significantly higher than those in control group (P<0.05). However, there were no significant differences in CRP, ESR and WBC between the cardiovascular involvement group and the cardiovascular uninvolved group (P>0.05). After intravenous immunoglobulin therapy, the levels of sST2 and IL-33 were decreased significantly in cardiovascular involvement group (P<0.05), while the levels of sST2 and IL-33 did not change significantly in cardiovascular uninvolved group (P>0.05). Pearson correlation analysis showed that the levels of sST2 and IL-33 in KD children were positively correlated with the Z value of echocardiography. Logistic regression analysis showed that sST2 and IL-33 were independent risk factors for cardiovascular injury in KD children (P<0.05). ROC curve analysis showed that sST2 and IL-33 had high diagnostic value for predicting cardiovascular injury in KD. Conclusions The levels of plasma sST2 and IL-33 are correlated with the degree of cardiovascular injury in children with KD. The analysis of sST2 and IL-33 is helpful to evaluate the degree of cardiovascular injury and predict the prognosis of children with KD.

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彭剑桥,王宏波,梁仙志,黎村艳,叶湘漓.可溶性肿瘤发生抑制蛋白2和白细胞介素33联合检测在川崎病患儿心血管受损早期诊断中的应用[J].中国动脉硬化杂志,2018,26(10):1016~1020.

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  • 收稿日期:2018-07-05
  • 最后修改日期:2018-09-04
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  • 在线发布日期: 2018-11-09