PAMP和NT-proBNP在预测川崎病冠状动脉损伤中的意义

目的 探讨肾上腺髓质素前体N端20肽(PAMP)和N端脑钠肽前体(NT-proBNP)在预测川崎病(KD)冠状动脉(简称冠脉)损伤中的价值.方法 选择2014年2月至2015年8月该院收治的急性期KD患儿196例,根据有无冠脉损伤分为KD冠脉损伤组和KD冠脉未损伤组;选择同期儿保中心的健康儿童50例作为对照组,检测3组对象血浆PAMP和NT-proBNP水平.结果 与对照组比较,KD患儿血浆PAMP和NT-proBNP水平均升高(P＜0.05),且KD冠脉损伤组均高于KD冠脉未损伤组(P＜0.05);KD患儿血浆中PAMP水平与NT-proBNP、白细胞计数(WBC)、中性粒细胞(NC)比例和红细胞沉降率(ESR)呈正相关(P＜0.05),而与血钠值和清蛋白呈负相关(P＜0.05);血浆中NT-proBNP水平与WBC、NC、C-反应蛋白(CRP)和ESR呈正相关(P＜0.05),而与血钠值和清蛋白呈负相关(P＜0.05);KD患儿血浆PAMP和NT-proBNP水平在预测冠脉损伤时曲线下面积(AUC)为0.989,灵敏度为93.24％,特异度为93.65％.结论 急性期KD患儿血浆PAMP和NT-proBNP水平升高,可作为冠脉受累的预测指标.

Significances of PAMP and NT-proBNP in predicting coronary artery injury in Kawasaki disease

Objective To investigate the significances of PAMP and NT-proBNP in predicting coronary artery injury in Kawasaki disease(KD).Methods A total of 196 cases of KD in this hospital from February 2014 to August 2015 were selected and divided into the KD injury group and KD non-injury group according to with orwithout coronary arterial injury.Contemporaneous 50 healthy children in the Child Health Care Center were selected as the control group.The plasma levels of PAMP and NT-proBNP were detected in 3 groups.Results Compared with the control group,the plasma levels of PAMP and NT-proBNP in the childrenpatients with KD were increased,moreover the KD injury group was higher than the KD non-injury group(P＜0.05).The plasma PAMP levels in KD children patients were positively correlated with NT-proBNP,white blood cell(WBC) count,neutrophil percentage and erythrocyte sedimentation rate(ESR)(P＜0.05),while were negatively correlated with the value of serum sodium and albumin(P＜0.05),the plasma levels of NT-proBNP were positively correlated white blood cell count,neutrophil percentage,C-reactive protein(CRP) and ESR(P＜0.05),while were negatively correlated with the levels of serum sodium and albumin(P＜0.05).The area under the curve(AUC) of plasma PAMP and NT-proBNP levels in predicting coronary artery damage in children patients with KD was 0.989,the sensitivity was 93.24％ and specificity was 93.65 ％.Conclusion The plasma levels of PAMP and NT-proBNP in children patients with acute phase of KD are elevated,which can serve as the predictive indicators of coronary artery lesion.