基于外周血细胞因子和淋巴细胞表达特征对川崎病发生冠脉损伤影响因素分析
nalysis of influencing factors of coronary artery lesions in Kawasaki disease based on the expression characteristics of cytokines and lymphocytes in peripheral blood
摘要 目的 观察川崎病(Kawasaki disease,KD)患儿外周血细胞因子和淋巴细胞的表达特征并分析冠脉损伤相关的影响因素。方法 收集2021年8月至2022年10月河北省儿童医院心内科收治的KD患儿50例,选择同期单纯发热患儿(除外KD)46例为发热对照(FC)组,54例正常体检患儿为正常对照(NC)组。检测三组患儿外周血细胞因子及淋巴细胞的表达水平,二元Logistic回归分析KD组与FC组及冠状动脉损伤(coronary artery lesions,CAL)组与无冠状动脉损伤(NCAL)组组间差异性指标,并绘制受试者工作特征曲线(ROC)。结果 1.KD组中IL-4、IL-6、IL-10、IL-5、IL-8水平高于FC组,IL-4、IL-6、IL-10、TNF-α、IFN-γ、IL-1β、IL-5、IL-12p70、IFN-α、IL-8水平高于NC组;CAL组中IL-4、IL-1β水平高于NCAL组,而IL-6水平降低,差异均有统计学意义(P<0.05)。2.KD组CD4+T细胞和总B细胞高于FC组,而总T细胞和CD8+T细胞占比较低;KD组总B细胞高于NC组,而CD8+T细胞和NK细胞占比降低。CAL组NK细胞高于NCAL组,而CD8+T细胞占比降低,均有统计学差异(P<0.05)。3.二元Logistic回归显示:(1)IL-6升高是KD发生的独立危险因素,OR值及95%置信区间(95%CI)为1.071(1.019,1.126);(2)CD8+T细胞和NK细胞是CAL的独立危险因素,OR值及95%CI分别为0.750(0.611,0.921)、1.652(1.192,2.289),二者联合预测CAL的灵敏度为81.25%,特异度为94.12%,约登指数为0.75,AUC为0.901,95%CI为(0.783,0.967)。结论 IL-6升高是KD发生的高危因素,CD8+T细胞降低和NK细胞升高对KD患儿发生CAL有一定的预测价值。
bstract Objective To observe the expression characteristics of peripheral blood cytokines and lymphocytes in children with Kawasaki disease (KD) and analyze influencing factors related to coronary artery lesions. Methods A total of 50 children with KD who were admitted to the Department of Cardiology of Children's Hospital of Hebei Province from August 2021 to October 2022 were collected. 46 children with simple fever (excluding KD) during the same period were selected as the febrile control (FC) group, and 54 children with normal physical examination were selected. Children were the normal control (NC) group. The expression levels of cytokines and lymphocytes in the peripheral blood of the three groups were detected, and binary Logistic regression analysis was used to analyze the differences between the KD group and the FC group, as well as between the coronary artery lesion(CAL) group and the non-coronary artery lesions (NCAL) group, the receiver operating characteristic curve(ROC) was drawn. Results 1. The levels of IL-4, IL-6, IL-10, IL-5, and IL-8 in the KD group were higher than those in the FC group, and the levels of IL-4, IL-6, IL-10, TNF-α, and IFN-γ, IL-1β, IL-5, IL-12p70, IFN-α, and IL-8 levels were higher than those in the NC group; the levels of IL-4 and IL-1β in the CAL group were higher than those in the NCAL group, while the levels of IL-6 were lower. Both were statistically significant (P<0.05). 2. CD4+T cells and total B cells in the KD group were higher than those in the FC group, while the proportions of total T cells and CD8+T cells were lower; the total B cells in the KD group were higher than those in the NC group, while the proportions of CD8+T cells and NK cells were higher than those in the NC group reduce. NK cells in the CAL group were higher than those in the NCAL group, while the proportion of CD8+ T cells was lower, with statistical differences (P<0.05). 3. Binary Logistic regression showed: (1) Elevation of IL-6 was an independent risk factor for KD, the OR value and 95% confidence interval (95%CI) were 1.071 (1.019, 1.126); (2) CD8+T Cells and NK cells are independent risk factors for CAL, and the OR value and 95%CI are 0.750 (0.611, 0.921) and 1.652 (1.192, 2.289), respectively. Youden index was 0.75, AUC was 0.901, and 95%CI was (0.783, 0.967). Conclusion Elevation of IL-6 is a high-risk factor for the occurrence of KD, and the decrease of CD8+T cells and the increase of NK cells have certain predictive value for the occurrence of CAL in children with KD.
张英谦、樊建春、刘露
儿科学基础医学临床医学
川崎病细胞因子淋巴细胞冠状动脉损伤
Kawasaki DiseaseytokinesLymphocyteoronary artery lesions
张英谦,樊建春,刘露.基于外周血细胞因子和淋巴细胞表达特征对川崎病发生冠脉损伤影响因素分析[EB/OL].(2023-06-14)[2025-08-25].https://chinaxiv.org/abs/202306.00179.点此复制
评论