临床儿科杂志
臨床兒科雜誌
림상인과잡지
2013年
9期
837-841
,共5页
川崎病%基质金属蛋白酶-9%诊断%ROC曲线%儿童
川崎病%基質金屬蛋白酶-9%診斷%ROC麯線%兒童
천기병%기질금속단백매-9%진단%ROC곡선%인동
Kawasaki disease%matrix metalloproteinase-9%diagnosis%ROC curve%child
目的探讨血浆基质金属蛋白酶-9（MMP-9）在川崎病早期诊断中的价值。方法采用回顾性巢式病例对照研究方法，分析比较早期川崎病患儿与过敏性紫癜（HSP）、呼吸道感染患儿、健康儿童的MMP-9水平，并分析MMP-9与血清降钙素原（PCT）、血沉（ESR）、C反应蛋白（CRP）的相关性；以受试者工作曲线（ROC）分析MMP-9、ESR和CRP诊断川崎病的截断值（cut-off值）及其灵敏度和特异度，并比较曲线下面积，分析各指标的诊断优势。结果早期川崎病患儿血浆MMP-9水平升高，并高于HSP、呼吸道感染患儿和健康儿童，差异均有统计学意义（P均<0.05)。ROC曲线结果显示，血浆MMP-9为90.23 ng/ml时，诊断川崎病的灵敏度、特异度和曲线下面积分别为83.3%、86.4%和0.904；ESR以56.5 mm/h时，分别为95.8%、66.1%和0.807；CRP以27.55 mg/L时，则分别为83.3%、74.6%和0.789。MMP-9在诊断效能上优于CRP和ESR。结论川崎病早期患儿血浆MMP-9水平明显升高，在截断值为90.23 ng/ml时诊断川崎病的灵敏度、特异度均较高。
目的探討血漿基質金屬蛋白酶-9（MMP-9）在川崎病早期診斷中的價值。方法採用迴顧性巢式病例對照研究方法，分析比較早期川崎病患兒與過敏性紫癜（HSP）、呼吸道感染患兒、健康兒童的MMP-9水平，併分析MMP-9與血清降鈣素原（PCT）、血沉（ESR）、C反應蛋白（CRP）的相關性；以受試者工作麯線（ROC）分析MMP-9、ESR和CRP診斷川崎病的截斷值（cut-off值）及其靈敏度和特異度，併比較麯線下麵積，分析各指標的診斷優勢。結果早期川崎病患兒血漿MMP-9水平升高，併高于HSP、呼吸道感染患兒和健康兒童，差異均有統計學意義（P均<0.05)。ROC麯線結果顯示，血漿MMP-9為90.23 ng/ml時，診斷川崎病的靈敏度、特異度和麯線下麵積分彆為83.3%、86.4%和0.904；ESR以56.5 mm/h時，分彆為95.8%、66.1%和0.807；CRP以27.55 mg/L時，則分彆為83.3%、74.6%和0.789。MMP-9在診斷效能上優于CRP和ESR。結論川崎病早期患兒血漿MMP-9水平明顯升高，在截斷值為90.23 ng/ml時診斷川崎病的靈敏度、特異度均較高。
목적탐토혈장기질금속단백매-9（MMP-9）재천기병조기진단중적개치。방법채용회고성소식병례대조연구방법，분석비교조기천기병환인여과민성자전（HSP）、호흡도감염환인、건강인동적MMP-9수평，병분석MMP-9여혈청강개소원（PCT）、혈침（ESR）、C반응단백（CRP）적상관성；이수시자공작곡선（ROC）분석MMP-9、ESR화CRP진단천기병적절단치（cut-off치）급기령민도화특이도，병비교곡선하면적，분석각지표적진단우세。결과조기천기병환인혈장MMP-9수평승고，병고우HSP、호흡도감염환인화건강인동，차이균유통계학의의（P균<0.05)。ROC곡선결과현시，혈장MMP-9위90.23 ng/ml시，진단천기병적령민도、특이도화곡선하면적분별위83.3%、86.4%화0.904；ESR이56.5 mm/h시，분별위95.8%、66.1%화0.807；CRP이27.55 mg/L시，칙분별위83.3%、74.6%화0.789。MMP-9재진단효능상우우CRP화ESR。결론천기병조기환인혈장MMP-9수평명현승고，재절단치위90.23 ng/ml시진단천기병적령민도、특이도균교고。
Objective To study the value of plasma level of matrix metalloproteinase-9 (MMP-9) for the early diagno-sis of Kawasaki disease. Methods The difference in MMP-9 level was studied by retrospective nested case-control method between children with early Kawasaki disease, Henoch-Sch?nlein purpura (HSP) or respiratory infection, and healthy control children. The associations of MMP-9 with serum procalcitonin, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also analyzed. The cutoff-value, sensitivity and speciifcity of MMP-9, ESR and CRP in diagnosis of Kawasaki disease were studied by ROC curve. The areas under ROC curves were compared among different diagnostic markers to deter-mine their signiifcances in diagnosis of Kawasaki disease. Results The plasma level of MMP-9 was increased in early phase of Kawasaki disease, and higher than that in children with HSP or respiratory infections and in healthy controls (P<0.05). If MMP-9, ESR and CRP cutoff value were set to be 90.23 ng/ml, 56.5 mm/h and 27.55 mg/L, the sensitivity, speciifcity and area under ROC curve was 83.3%, 86.4%and 0.904, 95.8%, 66.1%and 0.807, 83.3%, 74.6%and 0.789 respectively. The diagnostic performance of MMP-9 for Kawasaki disease was better than that of ESR and CRP. Conclusions The plasma level of MMP-9 is increased in the early stage of Kawasaki disease. The sensitivity and speciifcity of MMP-9 in diagnosis of Kawasaki disease are highest if cutoff value is set to be 90.23 ng/ml.
