摘要
目的:基于免疫指标,寻找对川崎病冠状动脉病变(Coronaryarterylesions,CAL)有预测价值的指标。方法:选择2020年4月~2024年12月该院收治的80例川崎病患儿作为研究对象,根据有无并发CAL分为CAL组(n=33)与无CAL组(n=47),收集两组患儿的人口学、血常规检查、血浆C反应蛋白(C-reactiveprotein,CRP)水平、血清铁蛋白水平及体液免疫指标(IgA、IgG、IgM、C3、C4、IgA/C3比值、IgG/C3比值及IgG/C4比值)。结果:CAL组与无CAL组CRP、血清铁蛋白、IgA、IgG、C3、IgA/C3比值、IgG/C3比值、IgG/C4比值差异具有统计学意义(P<0.05),而年龄、性别、体重及其他实验室指标差异无统计学意义(P>0.05)。多因素Logistic回归分析,结果显示,铁蛋白、IgA/C3比值、IgG/C3比值、IgG/C4比值是发生CAL的独立影响因素(P<0.05)。ROC曲线分析,铁蛋白、IgA/C3比值、IgG/C3比值、IgG/C4比值预测川崎病CAL的AUC依次为0.856、0.744、0.665、0.528,其中以铁蛋白和IgA/C3比值具有比较可靠的预测效能(AUC>0.7),而IgG/C3比值、IgG/C4比值的预测效能低下。结论:复合指标IgA/C3比值可能是预测川崎病患儿发生CAL的潜能标志物。
Objective:To identify potential predictive indicators for coronary artery lesions(CAL)in Kawasaki disease(KD)based on humoral immune markers.Methods:A total of 80 children with KD admitted to the hospital from April 2020 to December 2024 were enrolled and divided into a CAL group(n=33)and a non-CAL group(n=47)based on the presence or absence of CAL.Demographic data,routine blood tests,plasma C-reactive protein(CRP)levels,serum ferritin levels,and humoral immune markers(IgA,IgG,IgM,C3,C4,IgA/C3 ratio,IgG/C3 ratio,and IgG/C4 ratio)were collected and compared between the two groups.Results:Significant differences were observed between the CAL and non-CAL groups in CRP,ferritin,IgA,IgG,C3,IgA/C3 ratio,IgG/C3 ratio,and IgG/C4 ratio(P<0.05),while no significant differences were found in age,sex,weight,or other laboratory indicators(P>0.05).Multivariate logistic regression analysis revealed that ferritin,IgA/C3 ratio,IgG/C3 ratio,and IgG/C4 ratio were independent influencing factors for CAL(P<0.05).ROC curve analysis indicated,the AUC values for predicting coronary artery lesions(CAL)Kawasaki disease using ferritin,IgA/C3 ratio,IgG/C3 ratio,and IgG/C4 ratio were,0.744,0.665,and 0.528,respectively.Among these,ferritin and the IgA/C3 ratio demonstrated relatively reliable predictive efficacy(AUC>0.7),whereas the IgG/C3 and IgG/C4 ratios showed poor predictive performance.Conclusion:The IgA/C3 ratio may serve as a potential biomarker for predicting CAL in children with KD.
作者
王云亮
王志敏
曹思京
Wang Yun-liang;Wang Zhi-min;Cao Si-jin(Department of Pediatrics,Fuding City Hospital,Fuding 355200,Fujian,China)
