血清NT-proBNP、CRP与MMP-9在儿童川崎病中的临床意义

目的探讨川崎病(KD)患儿血清氨基末端B型钠尿肽原(NT-proBNP)、C反应蛋白(CRP)与基质金属蛋白酶9(MMP-9)的变化及临床意义。方法选取KD疑似患儿107例,其中临床确诊KD 68例KD组,包括54例完全型川崎病(CKD)和14例不完全型川崎病(IKD)患儿],以39例排除KD的患儿作为对照组,检测所有患儿血清NT-proBNP、CRP及MMP-9水平并作比较。采用受试者工作特征(ROC)曲线评价各项指标诊断KD的价值。结果KD组年龄及性别与对照组比较差异均有统计学意义(P<0.05)。KD组血清NT-proBNP、CRP和MMP-9水平与对照组比较,差异均有统计学意义(P=0.000)。CKD与IKD组之间血清NTproBNP、CRP和MMP-9水平差异均无统计学意义(P>0.05)。ROC曲线分析结果显示,NT-proBNP、CRP、MMP-9及3项指标的联合预测因子L鉴别诊断KD的曲线下面积(AUC)分别为0.858、0.861、0.689和0.938。结论血清NT-proBNP、CRP和MMP-9水平与KD密切相关,可作为儿童KD鉴别诊断的辅助指标。

Roles of serum NT-proBNP,CRP and MMP-9 in children with Kawasaki disease

Objective To investigate the changes and roles of N-terminal pro-B-type natriuretic peptide(NTproBNP),C-reactive protein(CRP)and matrix metalloproteinase 9(MMP-9)in children with Kawasaki disease(KD).Methods A total of 107 children suspected with KD were enrolled.Among the 107 children,68 children,including 54 cases of complete Kawasaki disease(CKD)and 14 cases of incomplete Kawasaki disease(IKD),were confirmed as KD group,and the other 39 children were enrolled as disease control group.The levels of serum NT-proBNP,CRP and MMP-9 were determined.Receiver operating characteristic(ROC)curve was used to assess the diagnostic efficiency of each index.Results Compared with disease control group,the age and sex of KD group had statistical significance(P<0.05).The levels of serum NT-proBNP,CRP and MMP-9 had statistical significance between KD and disease control groups(P=0.000).There was no statistical significance in NT-proBNP,CRP and MMP-9 between CKD and IKD groups(P>0.05).ROC curve analysis showed that the areas under the curves(AUC)of NT-proBNP,CRP and MMP-9 and combined determination predictor L in the differential diagnosis of KD were 0.858,0.861,0.689 and 0.938,respectively.Conclusions The levels of serum NT-proBNP,CRP and MMP-9 are closely related with KD,which can be used in the differential diagnosis of KD.