中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2015年
17期
88-91
,共4页
降钙素原%川崎病%冠状动脉损害%免疫球蛋白
降鈣素原%川崎病%冠狀動脈損害%免疫毬蛋白
강개소원%천기병%관상동맥손해%면역구단백
Procalcitonin%Kawasaki disease%Coronary artery lesion%Intravenous immunoglobulin
目的：评价川崎病患者急性期血清降钙素原(PCT)水平的变化对冠状动脉损害的预估价值。方法回顾性分析2011年4月~2014年12月中日友好医院住院的51例川崎病患者的临床资料。按照有无冠状动脉损害，分为冠状动脉损害组(CAL组，22例)和无冠状动脉损害组(nCAL组，29例)，选取同期住院的急性病毒感染患者24例作为对照组。所有入组患者均在入院后24 h内取血，采用免疫荧光法检测血清PCT。采用Mann-Whitney U检验比较各组间PCT水平的差异，采用卡方检验及ROC曲线分析评估PCT对冠状动脉损害的预估价值。结果川崎病患者血清PCT水平[0.50(0.12~1.63)μg/L]较对照组[0.11(0.05~0.24)μg/L]显著升高，差异有高度统计学意义(P<0.01)。CAL组血清PCT水平[0.20(0.07~1.15)μg/L]较nCAL组[0.96(0.17~2.10)μg/L]降低，但差异无统计学意义(P>0.05)。卡方检验提示PCT阴性可作为川崎病患者冠状动脉损害的预测因子(χ2=4.42，P<0.05)。 ROC曲线分析显示，当选取PCT≤0.34μg/L作为临界点时，对冠状动脉损害预测的灵敏度为0.682，特异度为0.655(95%CI：0.511~0.785，P<0.05)。结论川崎病患者急性期血清PCT水平较病毒感染患者明显升高，血清PCT水平对川崎病患者急性期冠状动脉损害有一定的阴性预测价值。
目的：評價川崎病患者急性期血清降鈣素原(PCT)水平的變化對冠狀動脈損害的預估價值。方法迴顧性分析2011年4月~2014年12月中日友好醫院住院的51例川崎病患者的臨床資料。按照有無冠狀動脈損害，分為冠狀動脈損害組(CAL組，22例)和無冠狀動脈損害組(nCAL組，29例)，選取同期住院的急性病毒感染患者24例作為對照組。所有入組患者均在入院後24 h內取血，採用免疫熒光法檢測血清PCT。採用Mann-Whitney U檢驗比較各組間PCT水平的差異，採用卡方檢驗及ROC麯線分析評估PCT對冠狀動脈損害的預估價值。結果川崎病患者血清PCT水平[0.50(0.12~1.63)μg/L]較對照組[0.11(0.05~0.24)μg/L]顯著升高，差異有高度統計學意義(P<0.01)。CAL組血清PCT水平[0.20(0.07~1.15)μg/L]較nCAL組[0.96(0.17~2.10)μg/L]降低，但差異無統計學意義(P>0.05)。卡方檢驗提示PCT陰性可作為川崎病患者冠狀動脈損害的預測因子(χ2=4.42，P<0.05)。 ROC麯線分析顯示，噹選取PCT≤0.34μg/L作為臨界點時，對冠狀動脈損害預測的靈敏度為0.682，特異度為0.655(95%CI：0.511~0.785，P<0.05)。結論川崎病患者急性期血清PCT水平較病毒感染患者明顯升高，血清PCT水平對川崎病患者急性期冠狀動脈損害有一定的陰性預測價值。
목적：평개천기병환자급성기혈청강개소원(PCT)수평적변화대관상동맥손해적예고개치。방법회고성분석2011년4월~2014년12월중일우호의원주원적51례천기병환자적림상자료。안조유무관상동맥손해，분위관상동맥손해조(CAL조，22례)화무관상동맥손해조(nCAL조，29례)，선취동기주원적급성병독감염환자24례작위대조조。소유입조환자균재입원후24 h내취혈，채용면역형광법검측혈청PCT。채용Mann-Whitney U검험비교각조간PCT수평적차이，채용잡방검험급ROC곡선분석평고PCT대관상동맥손해적예고개치。결과천기병환자혈청PCT수평[0.50(0.12~1.63)μg/L]교대조조[0.11(0.05~0.24)μg/L]현저승고，차이유고도통계학의의(P<0.01)。CAL조혈청PCT수평[0.20(0.07~1.15)μg/L]교nCAL조[0.96(0.17~2.10)μg/L]강저，단차이무통계학의의(P>0.05)。잡방검험제시PCT음성가작위천기병환자관상동맥손해적예측인자(χ2=4.42，P<0.05)。 ROC곡선분석현시，당선취PCT≤0.34μg/L작위림계점시，대관상동맥손해예측적령민도위0.682，특이도위0.655(95%CI：0.511~0.785，P<0.05)。결론천기병환자급성기혈청PCT수평교병독감염환자명현승고，혈청PCT수평대천기병환자급성기관상동맥손해유일정적음성예측개치。
Objective To assess the predictive value of serum procalcitonin (PCT) level on coronary artery lesion (CAL) in the acute phase of Kawasaki disease (KD). Methods Clinical data of 51 KD patients hospitalized in China-Japan Friendship Hospital from April 2011 to December 2014 were retrospectively analyzed. The KD patients were divided into CAL group (n=22) and nCAL group (n=29) according to the presence or absence of CAL in the acute phase, and 24 patients with acute viral infection during the same period were also enrolled in this study as a control group. Blood samples of all patients were obtained in 24 hours of admission and PCT levels were detected by immunofluorescence technique. Mann-W hitne y U tests were used to assess the statistical significance of PCT value among the different groups. χ2 test and receiver operating characteristics (ROC) curve analysis were performed to explore the power of serum PCT level in predicting the CAL in the acute phase of KD. Results The level of serum PCT in KD patients [0.50 (0.12-1.63) μg/L] was statistically higher than that in control group [0.11 (0.05-0.24)μg/L] (P<0.01). The serum PCT value in CAL group [0.20 (0.07-1.15) μg/L] was lower than that in nCAL group [0.96 (0.17-2.10) μg/L], but there was no statistical significance (P> 0.05). The χ2 test showed that, PCT negative was a predictive factor of CAL in KD pa-tients (χ2=4.42, P<0.05). ROC curve analysis indicated that, PCT≤0.34μg/L was the cutoff value, the sensitivity was 0.682 and the specialty was 0.655 (95%CI: 0.511-0.785, P< 0.05). Conclusion The level of serum PCT in KD pa-tients is statistically higher than that in patients with viral infection. Serum PCT level has some negative predictive val-ue on CAL in the acute phase of KD patients.
