| 李丽,张谦,刘冬,等.川崎病合并支原体感染病儿瓣膜炎性损伤与 IL-6/STAT3信号通路表达变化的关系分析[J].安徽医药,2024,28(12):2397-2403. |
| 川崎病合并支原体感染病儿瓣膜炎性损伤与 IL-6/STAT3信号通路表达变化的关系分析 |
| Relationship between valvular inflammatory injury and changes of IL-6/STAT3 signaling pathways in children with Kawasaki disease and mycoplasma infection |
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| DOI：10.3969/j.issn.1009-6469.2024.12.013 |
| 中文关键词: 心瓣膜炎 黏膜皮肤淋巴结综合征 支原体感染 白细胞介素 -6 信号转导及转录激活蛋白 3 危险因素 预测价值 |
| 英文关键词: Valvulitis Mucocutaneous lymph node syndrome Mycoplasma infections Interleukin-6 Signal transducer and ac-tivator of transcription protein 3 Risk factor Predictive value |
| 基金项目:2020年河南省医学科技攻关计划联合共建项目( LHGJ20200645) |
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| 中文摘要: |
| 目的探讨川崎病( KD)合并支原体感染病儿瓣膜炎性损伤与白细胞介素 -6(IL-6)/信号转导及转录激活蛋白 3(STAT3)信号通路表达变化的关系。方法前瞻性选取 2018年 1月至 2022年 12月安阳市妇幼保健院收治的 50例 KD合并肺炎支原体( MP)(KD-MP)感染病儿为感染组，另选取同期收治的 106例单纯 KD病儿为未感染组，比较感染组与未感染组病儿瓣膜炎性损伤情况。再根据 KD病儿是否伴有冠状动脉损伤( CAL)损伤分为 CAL组( n=84)、无 CAL组( n=72)比较两组病儿 IL-6和 STAT3表达水平，通过多因素 logistic回归分析 KD病儿发生 CAL的危险因素。比较 KD并 CAL不同预后，病儿 IL-6和 STAT3表达变化，使用受试者操作特征曲线( ROC曲线)分析 IL-6、STAT3水平对 KD并 CAL病儿预后的预测价值。结果感染组 KD病儿发热时间、住院时间、初诊 CAL发生率均高于未感染组( P<0.05)；感染组 KD病儿 C反应蛋白( CRP)、降钙素原(PCT)、红细胞沉降率( ESR)、 IL-6 mRNA表达水平和 STAT3 mRNA表达水平均高于未感染组［( 51.32±12.62)mg/L比( 36.58±10.98)mg/L，(1.33±0.35)μg/L比( 1.21±0.31)μg/L，(84.69±15.66)mm/h比( 49.62±16.43)mm/h，4.14±1.09比 3.06±1.15，2.81±0.89比 1.68±0.54，均 P<0.05］。 CAL组病儿 IL-6、STAT3 mRNA表达水平高于无 CAL组( 4.13±1.22比 2.56±0.87，2.46±0.71比 1.55±0.44，均 P<0.05)；多因素回归分析结果显示， MP感染、 IL-6 mRNA、STAT3 mRNA表达是 KD病儿发生 CAL的独立危险因素(均 P<0.05)。 KD并 CAL预后良好组病儿 IL-6、STAT3 mRNA表达水平低于预后不良组( 3.57±1.06比 4.57±1.13，1.94±0.58比 2.87±0.87，均 P<0.05)，ROC曲线结果显示 IL-6、STAT3及其联合预测 KD并 CAL预后的曲线下面积( AUC)分别为 0.75、0.81、 0.91，且联合检测的 AUC高于 IL-6、STAT3单独检测(均 P<0.05)。结论 KD合并 MP病儿瓣膜炎性损伤更为严重， IL-6/STAT3信号通路活化是其危险因素，且该信号通路对 KD并 CAL病儿预后有较高的预测价值。 |
| 英文摘要: |
| Objective To explore the relationship between valvular inflammatory injury and changes of interleukin-6 (IL-6)/signaltransducer and activator of transcription protein 3 (STAT3) signaling pathways in children with Kawasaki disease (KD) and mycoplasmainfection.Methods A total of 50 children with KD and Mycoplasma pneumoniae (KD-MP) infection in Anyang Maternal and ChildHealth Hospital between January 2018 and December 2022 were prospectively enrolled as infection group , while other 106 childrenonly with KD during the same period were enrolled as non-infection group. The valvular inflammatory injury in the two groups was com-pared. According to presence or absence of coronary artery lesion (CAL), children with KD were divided into CAL group (n=84) and non-CAL group (n=72), and expression levels of IL-6 and STAT3 were compared between the two groups. The risk factors of CAL in KDchildren were analyzed by multivariate logistic regression analysis. The changes of IL-6 and STAT3 in children with different prognosis were compared. The predictive value of IL-6 and STAT3 for prognosis of children with KD and CAL was analyzed by receiver operating characteristic curves (ROC curves).Results The fever time, hospitalization time and incidence of newly diagnosed CAL in infection group were higher than those in non-infection group (P<0.05). The levels of C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), IL-6 mRNA and STAT3 mRNA in infection group were higher than those in non-infection group [(51.32± 12.62) mg/L vs. (36.58±10.98) mg/L, (1.33±0.35) μg/L vs. (1.21±0.31) μg/L, (84.69±15.66) mm/h vs. (49.62±16.43) mm/h, 4.14±1.09 vs. 3.06±1.15, 2.81±0.89 vs. 1.68±0.54, P<0.05]. The expression levels of IL-6 and STAT3 mRNA in CAL group were higher than those in non-CAL group (4.13±1.22 vs. 2.56±0.87, 2.46±0.71 vs. 1.55±0.44, P<0.05). The results of multivariate regression analysis showed that MP infection, IL-6 and STAT3 were independent risk factors of CAL in KD children (P<0.05). The expression levels of IL-6 and STAT3 mRNA in good prognosis group were lower than those in poor prognosis group (3.57±1.06 vs. 4.57±1.13, 1.94±0.58 vs. 2.87± 0.87, P<0.05). The results of ROC curves analysis showed that area under curve (AUC) values of IL-6, STAT3 and combined detectionfor predicting the prognosis were 0.75, 0.81 and 0.91, respectively. AUC of combined detection was greater than that of single index (P< 0.05). Conclusions The valvular inflammatory injury is severer in children with KD and MP. The activated IL-6/STAT3 signalingpathways are risk factors for valvular inflammatory injury, which have high prognostic value in children with KD and CAL. |
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