洪 柳,肖凤林,程家乐,张 丽,陈 丹.心电图QT间期离散度联合25-(OH)D、GDF-15、PTX3对川崎病患儿冠状动脉损伤的评估价值[J].,2024,(14):2709-2713 |
心电图QT间期离散度联合25-(OH)D、GDF-15、PTX3对川崎病患儿冠状动脉损伤的评估价值 |
Value of Electrocardiogram QT Interval Dispersion Combined with 25-(OH)D, GDF-15 and PTX3 in the Evaluation of Coronary Artery Lesions in Children with Kawasaki Disease |
投稿时间:2024-02-03 修订日期:2024-02-28 |
DOI:10.13241/j.cnki.pmb.2024.14.020 |
中文关键词: 心电图 QT间期离散度 25-(OH)D GDF-15 PTX3 川崎病 冠状动脉损伤 |
英文关键词: Kawasaki disease Electrocardiogram QT interval dispersion 25-(OH)D GDF-15 PTX3 Coronary artery lesions |
基金项目:湖南省卫生健康委科研计划项目(D202303037007) |
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中文摘要: |
摘要 目的:探讨心电图QT间期离散度(QTd)联合25-羟维生素D[25-(OH)D]、生长分化因子-15(GDF-15)、正五聚蛋白3(PTX3)对川崎病患儿冠状动脉损伤(CAL)的评估价值。方法:选择2018年6月至2023年6月我院收治的180例川崎病患儿,根据是否发生CAL将其分为CAL组(36例)和非CAL组(144例)。所有患儿接受心电图检查获得QTd、校正QT离散度(QTcd),同时检测血清25-(OH)D、GDF-15、PTX3水平。多因素Logistic回归分析影响川崎病患儿发生CAL的因素,并构建多指标联合应用的Log P模型。受试者工作特征(ROC)曲线分析QTd、25-(OH)D、GDF-15、PTX3对川崎病患儿CAL发生的预测价值。结果:CAL组QTd、QTcd、GDF-15、PTX3水平高于非CAL组(P<0.05),25-(OH)D水平低于非CAL组(P<0.05)。治疗无应答、高QTd、高QTcd、高GDF-15、高PTX3是川崎病患儿发生CAL的危险因素(P<0.05),高25-(OH)D是保护因素(P<0.05)。构建多指标联合应用的Log P模型分别为:A:心电图参数模型:Ln(P/1-P)=0.512×QTd+0.596×QTcd;B:血清3指标模型:Ln(P/1-P)=0.712×GDF-15+0.626×PTX3-0.609×25-(OH)D;C:5因子联合应用模型(上述A+B模型):Ln(P/1-P)=0.512×QTd+0.596×QTcd+0.712×GDF-15+0.626×PTX3-0.609×25-(OH)D。经ROC分析知,A、B、C 模型对川崎病患儿发生CAL均有一定的预测效能,其ROC-AUC(0.95CI)分别为:0.709(0.490~0.921)、0.787(0.579~0.966)、0.835(0.699~0.955)。其中C联合应用模型的预测效能最高。结论:川崎病伴CAL患儿的QTd增加、QTcd 增加、GDF-15升高、PTX3升高,25-(OH)D下降,联合检测上述指标对川崎病患儿CAL的发生具有较高的预测效能。 |
英文摘要: |
ABSTRACT Objective: To investigate the value of electrocardiogram QT interval dispersion (QTd) combined with 25-hydroxyvitamin D [25-(OH) D], growth differentiation factor-15 (GDF-15) and pentraxin 3 (PTX3) in the evaluation of coronary artery lesions (CAL) in children with Kawasaki disease. Methods: 180 children with Kawasaki disease admitted to our hospital from June 2018 to June 2023 were selected, and patients were divided into CAL group (36 cases) and non-CAL group (144 cases) according to whether CAL occurred. All children received electrocardiogram examination to obtain QTd and corrected QT dispersion (QTcd), and serum 25-(OH)D, GDF-15 and PTX3 levels were detected. The factors affecting the occurrence of CAL in children with Kawasaki disease were analyzed by multivariate Logistic regression analysis, and a Log P model of multi-index combined application was constructed. The predictive value of QTd, 25-(OH)D, GDF-15 and PTX3 for CAL in children with Kawasaki disease were analyzed by receiver operating characteristic (ROC) curve. Results: The levels of QTd, QTcd, GDF-15 and PTX3 in CAL group were higher than those in non-CAL group (P<0.05), and the level of 25-(OH)D was lower than that in non-CAL group(P<0.05). Treatment non-response, high QTd, high QTcd, high GDF-15, and high PTX3 were risk factors for CAL in children with Kawasaki disease (P<0.05), and high 25-(OH)D was a protective factor (P<0.05). The Log P models of multi-index combined application were constructed as follows: A: electrocardiogram parameter model: Ln (P/1-P)=0.512 ×QTd+0.596 QTcd; B: serum 3 index model: Ln (P/1-P)=0.712×GDF-15+0.626×PTX3-0.609×25- (OH)D; C: 5-factor joint application model (above A+B model): Ln (P/1-P)=0.512×QTd+0.596 QTcd+0.712×GDF-15+0.626×PTX3-0.609×25-(OH)D. ROC analysis showed that, models A, B and C had certain predictive efficacy for CAL in children with Kawasaki disease, and their ROC-AUC (0.95CI) were 0.709 (0.490~0.921), 0.787 (0.579~0.966) and 0.835 (0.699~0.955) respectively. C combined application model has the highest prediction efficiency. Conclusion: The QTd increase, QTcd increased, GDF-15 increase, PTX3 increase, and 25-(OH)D decrease in children with Kawasaki disease with CAL, the combined detection of the above indicators has a high predictive efficiency for the occurrence of CAL in children with Kawasaki disease. |
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