血清NT-proBNP与IL-6在川崎病患儿中的水平变化及临床意义

目的探讨血清N末端B型脑钠肽原(NT-proBNP)、白细胞介素-6(IL-6)在川崎病(KD)患儿中的表达水平及临床意义。方法收集2014年8月-2016年12月沧州市中心医院收治的KD患儿为病例组(n=50),并根据是否合并冠脉损伤将其分为冠脉损伤组(n=17)和非冠脉损伤组(n=33),并于同期选取因发热性疾病入院治疗的非KD患儿为对照组(n=50)。采用电化学发光法检测血清NT-proBNP水平,酶联免疫吸附法检测血清IL-6水平。结果病例组患儿血清NT-proBNP、IL-6水平均高于对照组,差异有统计学意义(P<0.05)。冠脉损伤组患儿血清NT-proBNP、IL-6水平均高于非冠脉损伤组,差异有统计学意义(P<0.05)。经Pearson积差相关分析,病例组患儿血清NT-proBNP与IL-6呈正相关关系(r=0.639,P<0.05)。NT-proBNP的ROC曲线下面积AUC为0.862(95%CI:0.755~0.970),最佳临界值为1.07μg/L,灵敏度为89.21%,特异性为92.24%;IL-6的ROC曲线下面积AUC为0.904(95%CI:0.813~0.995),最佳临界值为58.21 ng/ml,灵敏度为93.41%,特异性为89.16%;NT-proBNP联合IL-6对KD的AUC为0.915(95%CI:0.837~0.993),灵敏度为96.27%,特异度为92.24%。结论 NT-proBNP、IL-6在川崎病患儿血清中明显升高,早期联合检测可作为辅助诊断川崎病的重要指标。

Changes and clinical significance of serum NT-proBNP and IL-6 levels in children with Kawasaki disease

Objective To explore the expression levels and clinical significance of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and interleukin-6 (IL-6) in children with Kawasaki disease (KD). Methods Children with KD who were hospitalized in Cangzhou Central Hospital from August 2014 to December 2016 served as the case group (n=50), and then they were divided into coronary artery injury group (n=17) and non-coronary artery injury group (n=33) according to the coronary artery injury. At the same time, non-KD children who were hospitalized for febrile disease were selected as the control group (n=50). The serum NT-proBNP levels were detected by electrochemiluminescence, and the serum IL-6 levels were determined by enzyme-linked immunosorbent assay. Results The serum NT-proBNP and IL-6 levels in the case group were both higher than those in the control group, showing a statistically significant difference (P<0.05). The serum NT-proBNP and IL-6 levels were both higher in coronary artery injury group than in non-coronary artery injury group, with statistically significant differences (P<0.05). Pearson's product-moment correlation analysis showed that serum NT-proBNP was positively correlated with IL-6 in the case group (r=0.639, P<0.05). According to the receiver operating characteristic curve (ROC) analysis, the area under ROC curve (AUC) of NT-pro BNP for detection of KD was 0.862(95%CI:0.755-0.970), and the optimal cut-off value, sensitivity and specificity were 1.07 ug/L, 89.21% and 92.24% respectively. The AUC of IL-6 for detection of KD was 0.904 (95%CI:0.813-0.995), and the optimal cut-off value, sensitivity and specificity were 58.21 ng/ml, 93.41% and 89.16% respectively. The AUC of NT-proBNP combined with IL-6 for detection of KD was 0.915 (95%CI:0.837-0.993), with the sensitivity and specificity being 96.27% and 92.24% respectively. Conclusions The serum NT-proBNP and IL-6 in children with KD are significantly increased; and hence, early detection of serum NT-proBNP combined with IL-6 can be used as the important indexes for auxiliary diagnosis of KD.