| 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].现代生物医学进展英文版,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 |
| Received:February 03, 2024 Revised:February 28, 2024 |
| 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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