血清NT-proBNP血沉白蛋白联合LDH评估川崎病合并冠状动脉病变的价值研究

doi:10.3969/j.issn.1006-6233.2025.12.021

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摘要 目的: 探究氨基末端B型钠尿肽前体(NT-proBNP)、血沉(ESR)、白蛋白(ALB)联合乳酸脱氢酶(LDH)评估川崎病(KD)合并冠状动脉病变(CAL)的价值。方法: 随机抽取2023年10月至2025年3月期间在本院诊断川崎病并进行心脏超声检查的149例患儿的临床资料,并进行回顾性分析,依据是否合并冠状动脉病变分CAL组(KD合并CAL,n=38)和非CAL组(KD未合并CAL,n=111)。比较CAL组、非CAL组临床资料,采用t检验或秩和检验比较两组之间血清NT-proBNP、血沉(ESR)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、天冬氨酸转氨酶(AST)、丙氨酸氨基转移酶(ALT)、血钠(Na)、白蛋白(ALB)差异;并进行多因素Logistic回归分析以上实验室指标与川崎病合并冠状动脉病变的关系;采用受试者工作特征(ROC)曲线下面积(AUC)评估NT-proBNP、ESR、LDH及ALB预测KD合并CAL的价值。结果: CAL组NT-proBNP、ESR、AST、ALT、LDH均高于非CAL组,ALB、Na均低于非CAL组,差异均有统计学意义(P<0.05);多因素Logistic回归分析显示,NT-proBNP(OR=1.003,95%CI:1.001~1.005)、ESR(OR=1.181,95%CI:1.079~1.292)、LDH(OR=1.080,95%CI:1.036~1.125)、ALB(OR=0.584,95%CI:0.400~0.855)均为KD合并CAL的影响因素(P<0.05);NT-proBNP、ESR、LDH、ALB预测KD合并CAL的AUC分别为0.856(95%CI:0.789~0.908)、0.733(95%CI:0.654~0.802)、0.720(95%CI:0.641~0.791)、0.800(95%CI:0.727~0.861)(P<0.05),上述指标联合预测KD合并CAL的AUC为0.980(95%CI:0.943~0.996)(P<0.05)。结论: NT-proBNP、ESR、LDH、ALB是KD患儿发生CAL影响因素,且可作为CAL预测指标。

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	方文静
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关键词 ：川崎病, 氨基末端B型钠尿肽前体, 血沉, 乳酸脱氢酶, 白蛋白, 冠状动脉病变

Abstract：Objective: To explore the value of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), erythrocyte sedimentation rate (ESR),albumin(ALB), and lactate dehydrogenase (LDH) in evaluating Kawasaki disease (KD) with coronary artery lesions (CAL). Methods: The clinical data of 149 patients who were diagnosed with KD and received cardiac ultrasound examination in the hospital from October 2023 to March 2025 were retrospectively analyzed. According to the results of ultrasound examination, the enrolled patients were divided into CAL group (KD with CAL, n=38) and non-CAL group (KD without CAL, n=111). The clinical data were compared between the CAL group and the non-CAL group. The differences in serum NT-proBNP, ESR, creatine kinase (CK), creatine kinase-MB (CK-MB), LDH, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood sodium (Na), and ALB were compared between the two groups by t-test or rank sum test. Multivariate Logistic regression analysis was performed to analyze the relationship between the above laboratory indicators and KD with CAL. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the value of NT-proBNP, ESR, LDH, and ALB in predicting KD with CAL. Results: NT-proBNP, ESR, AST, ALT, and LDH in the CAL group were higher than those in the non-CAL group, while ALB and Na were lower than those in the non-CAL group, with statistical differences (P<0.05). Multivariate Logistic regression analysis indicated that NT-proBNP (OR=1.003, 95%CI: 1.001~1.005), ESR (OR=1.181, 95%CI: 1.079~1.292), LDH (OR=1.080, 95%CI: 1.036~1.125), and ALB (OR=0.584, 95%CI: 0.400~0.855) were the influencing factors of KD with CAL (P<0.05). The AUCs of NT-proBNP, ESR, LDH and ALB for predicting KD with CAL were 0.856 (95%CI: 0.789~0.908), 0.733 (95%CI: 0.654~0.802), 0.720 (95%CI: 0.641~0.791) and 0.800 (95%CI: 0.727~0.861), respectively (P<0.05), and the AUC of the combination of the above indicators for predicting KD with CAL was 0.980 (95%CI: 0.943~0.996) (P<0.05). Conclusion: NT-proBNP, ESR, LDH, and ALB are influencing factors of CAL occurrence in children with KD, and can be used as predictors of CAL.

Key words： Kawasaki disease N-terminal pro-brain natriuretic peptide Erythrocyte sedimentation rate Albumin Lactate dehydrogenase Coronary artery lesions

基金资助:2022年度安徽省卫生健康科研项目立项项目,(编号:AHWJ2022b066)

引用本文:

方文静, 王丹丹, 童琳. 血清NT-proBNP血沉白蛋白联合LDH评估川崎病合并冠状动脉病变的价值研究[J]. 河北医学, 2025, 31(12): 2068-2073.
FANG Wenjing, WANG Dandan, et al. The Value of Serum NT-proBNP Erythrocyte Sedimentation Rate Albumin Combined with LDH in Evaluating Kawasaki Disease Complicated with Coronary Artery Lesions. HeBei Med, 2025, 31(12): 2068-2073.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.12.021 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I12/2068

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