| 米艳茹,张力广,范爱红.金属蛋白酶1组织抑制剂、 β-半乳糖凝集素 3、生长分化因子 -15、脂质运载蛋白 -2与川崎病病儿冠状动脉损害的关系研究[J].安徽医药,2026,30(4):781-785. |
| 金属蛋白酶1组织抑制剂、 β-半乳糖凝集素 3、生长分化因子 -15、脂质运载蛋白 -2与川崎病病儿冠状动脉损害的关系研究 |
| Study on the relationship between metalloproteinase-1 tissue inhibitor, β-galactosaminoglycan 3, growth differentiation factor-15, lipoprotein-2 and coronary artery damage in children with Kawasaki disease |
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| DOI：10.3969/j.issn.1009-6469.2026.04.028 |
| 中文关键词: 川崎病 冠状动脉损害 金属蛋白酶1组织抑制剂 β-半乳糖凝集素 3 生长分化因子 -15 脂质运载蛋白 -2 |
| 英文关键词: Kawasaki disease Coronary artery lesions Tissue inhibitor of metalloproteinase 1 β-galectin 3 Growth differenti-ation factor-15 Lipocalin-2 |
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| 摘要点击次数: 196 |
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| 中文摘要: |
| 目的探讨金属蛋白酶1组织抑制剂( TIMP1)、 β-半乳糖凝集素 3(GAL-3)、生长分化因子 -15(GDF-15)和脂质运载蛋白-2(Lcn 2)与川崎病病儿冠状动脉损害(CAL)的关系。方法选取 2019年 4月至 2023年 3月唐山中心医院收治的接受大剂量丙种球蛋白联合阿司匹林治疗后发生 CAL的川崎病病儿，设为 CAL组(n=61)未发生 CAL的病儿设为非冠状动脉损害( NCAL)组(n=111)。检测并比较两组血清 TIMP1、GAL-3、GDF-15和 Lcn 2水平及基线资料，的差异；采用 logistic回归分析探索川崎病病儿冠状动脉损害的影响因素；绘制受试者操作特征曲线(ROC曲线)并用曲线下面积(AUC)评价 TIMP1、GAL-3、GDF-15和 Lcn 2对川崎病病儿冠状动脉损害的预测价值。结果 CAL组 TIMP1低于，NCAL组［(276.10±41.34)μg/L比( 302.67±42.50)μg/L］，GAL-3、GDF-15和 Lcn 2水平均高于 NCAL组［(61.34±10.30)ng/L比(26.80±7.74)ng/L、(1 941.27±84.39)μg/L比(1 497.82±80.61)μg/L、(104.61±9.14)μg/L比(87.32±8.45)μg/L］(P<0.05)。CAL组病儿 1~5岁占比低于 NCAL组， <1岁占比、不典型川崎病占比、总发热天数、治疗前发热天数、 CRP、PLT及 ALB水平高于 NCAL组(P<0.05)。logistic回归分析显示，年龄 <1岁、治疗前发热时间、 GAL-3、GDF-15和 Lcn 2均是影响川崎病病儿发生 CAL的危险因素(OR=2.92、2.20、2.60、2.44、3.06，均 P<0.05)TIMP1是保护因素(OR =0.87，P<0.05)。TIMP1、GAL-3、GDF-15和 Lcn 2预测川崎病病儿发生 CAL的 AUC分别为 0.89、0.92、0.79、0，.90，4项联合的预测效能优于单独应用( Z=3.96、4.02、5.32、4.36，均 P<0.05)。结论血清 TIMP1、GAL-3、GDF-15和 Lcn 2在川崎病冠状动脉损害病儿中异常升高，四者与冠状动脉损害的发生关系密切，且对冠状动脉损害具有较高的预测价值。 |
| 英文摘要: |
| Objective To investigate the relationship between tissue inhibitor of metalloproteinase 1 (TIMP1), β-galectin 3 (GAL-3), growth differentiation factor-15 (GDF-15) and lipocalin-2 (Lcn 2) in Kawasaki coronary artery lesions (CAL) in children with the dis.ease.Methods Children with Kawasaki disease who developed CAL after receiving high-dose gamma globulin combined with aspirintreated in Tangshan Central Hospital from April 2019 to March 2023 were selected as CAL group (n=61), and children who did not de-velop CAL were selected as NCAL group (n=111). The differences in serum TIMP1, GAL-3, GDF-15 and Lcn 2 levels and baseline da-ta between the two groups were detected and compared. The influencing factors of coronary artery lesions in children with Kawasaki dis-ease were analyzed by logistic regression analysis. The receiver operating characteristic curve (ROC curve) was drawn, and the area un-der the curve (AUC) was used to evaluate the predictive value of TIMP1, GAL-3, GDF-15 and Lcn 2 for coronary artery lesions in children with Kawasaki disease. Results TIMP1 in CAL group was lower than that in NCAL group [(276.10±41.34) μ g/L vs. (302.67±42.50) μ g/L], GAL-3, GDF-15 and Lcn2 levels were higher than those in NCAL group [(61.34±10.30)ng/L vs. (26.80± 7.74) ng/L,(1 941.27±84.39) μg/L vs. (1 497.82±80.61) μg/L, (104.61±9.14) μg/L vs. (87.32±8.45) μg/L] (P<0.05). The proportion of children aged 1-5 years in the CAL group was lower than that in the NCAL group, and the proportion of children younger than 1 year and atypical Kawasaki disease, total fever days, fever days before treatment, CRP, PLT and ALB levels were higher than those in theNCAL group (P < 0.05). Logistic regression analysis showed that age < 1 year old, fever time before treatment, GAL-3, GDF-15 and Lcn2 were all risk factors for the occurrence of CAL in children with Kawasaki disease (OR=2.92, 2.20, 2.60, 2.44, 3.06, all P < 0.05), and TIMP1 was a protective factor (OR=0.87, all P < 0.05). The AUCs of TIMP1, GAL-3, GDF-15 and Lcn 2 for predicting CAL in chil-dren with Kawasaki disease were 0.89, 0.92, 0.79, 0.90, respectively, and the combined efficacy of the four factors was superior to thatof single application (Z=3.96, 4.02, 5.32, 4.36, P<0.05).Conclusions Serum TIMP1, GAL-3, GDF-15 and Lcn 2 are abnormally ele-vated in children with coronary artery lesions in Kawasaki disease. The four are closely related to the occurrence of coronary artery le-sions and have high predictive value for coronary artery lesions. |
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