河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (3): 340-343.doi: 10.3969/j.issn.1007-3205.2021.03.019

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血清Omentin-1和Lp-PLA2水平检测在川崎病中的应用价值

  

  1. 1.西安交通大学第一附属医院检验科，陕西 西安710061；2.西安交通大学附属红会医院检验科，
    陕西 西安 710054；3.陕西省咸阳市第一人民医院儿科，陕西 咸阳 712000
  • 出版日期:2021-03-25 发布日期:2021-04-02
  • 作者简介:刘懿（1986-），女，陕西西安人，西安交通大学第一附属医院主管检验师，医学学士，从事医学检验研究。
  • 基金资助:
    陕西省创新能力支撑计划项目（2020PT-007）

Application value of serum omentin-1 and Lp-PLA2 levels in Kawasaki disease

  1. 1.Department of Clinical Laboratory, the First Affiliated Hospital of Xi′an Jiaotong University, Shaanxi
    Province, Xi′an 710061, China; 2.Department of Clinical Laboratory, Red Cross Hospital Affiliated to
    Xi′an Jiaotong University, Shaanxi Province, Xi′an 710061, China; 3. Department of Pediatrics,
    the First People′s Hospital of Xianyang City, Shaanxi Province, Xianyang 712000, China
  • Online:2021-03-25 Published:2021-04-02

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摘要： 目的  探讨血清网膜素1(Omentin-1)和脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2，Lp-PLA2)水平检测在川崎病(Kawasaki disease,KD)中的临床应用价值。
方法  选择KD患儿93例，依据超声心动图结果分为冠状动脉正常(normal coronary artery,NCA,54例)组和冠状动脉病变(coronary artery disease,CAD,39例)组。另选取健康体检者30例作为对照组。酶联免疫吸附法检测所有受试者血清Omentin-1和Lp-PLA2水平；彩色多普勒超声检查舒张期左侧冠状动脉左主干(left main coronary artery,LMCA)内径、左前降支(left anterior descending coronary artery,LADC)内径、右侧冠状动脉近段(proximal right coronary artery,PRCA)内径。分析上述指标与KD的相关性。
结果  NCA组和CAD组Omentin-1水平低于对照组，Lp-PLA2水平高于对照组，CAD组Omentin-1水平低于NCA组，Lp-PLA2水平高于NCA组,差异有统计学意义(P＜0.05)。CAD组LMCA内径、LADC内径和PRCA内径明显高于NCA组和对照组,差异有统计学意义(P＜0.05)；NCA组和对照组LMCA内径、LADC内径和PRCA内径差异无统计学意义(P＞0.05)。相关性分析结果显示，CAD组中Omentin-1与LMCA内径、LADC内径和PRCA内径呈负相关（P＜0.05）。Lp-PLA2与LMCA内径、LADC内径和PRCA内径呈正相关（P＜0.05）。ROC曲线分析结果显示，血清Omentin-1和Lp-PLA2诊断KD的AUC分别为［0.770(95%CI：0.635~0.905,P＜0.001)，0.805(95%CI：0.685~0.926,P＜0.001)］，敏感度和特异度分别为69.0%和93.7%，82.8%和81.2%。血清Omentin-1和Lp-PLA2诊断KD冠状动脉损伤的AUC分别为［0.748(95%CI：0.612~0.883,P＜0.001)，0.756(95%CI：0.619~0.893，P＜0.001)］，敏感度和特异度分别为58.6%和93.9%，69.0%和88.6%。
结论  血清Omentin-1和Lp-PLA2水平检测可应用于KD疾病的诊断,并可以评价KD患儿冠状动脉的损伤状况。

关键词: 黏膜皮肤淋巴结综合征, 网膜素1, 脂蛋白相关磷脂酶A2

Abstract: Objective  To explore the clinical application value of serum levels of omentin-1 and lipoprotein-associated phospholipase A2(Lp-PLA2) in Kawasaki disease(KD).
Methods  A total of 93 children with KD were divided into normal coronary artery(NCA) group(n=54) and coronary artery disease(CAD) group(n=39) according to the results of echocardiography. Another 30 healthy people were selected as the control group. The serum levels of omentin-1 and Lp-PLA2 were detected by enzyme-linked immunosorbent assay(ELISA). The internal diameters of left main coronary artery(LMCA), left anterior descending coronary artery(LADC), and right proximal coronary artery(PRCA) were detected by color doppler ultrasound. The correlation between the above indexes and KD was analyzed.
Results  The level of omentin-1 was lower whereas the level of Lp-PLA2 was higher in NCA group and CAD group, as compared with those in control group. The level of omentin-1 was lower whereas the level of Lp-PLA2 was higher in CAD group, as compared with those in NCA group(P ＜ 0.05). The internal diameters of LMCA, LADC and PRCA in CAD group were significantly higher than those in NCA group and control group(P＜0.05). There was no significant difference in the internal diameter of LMCA, LADC and PRCA between NCA group and control group(P＞0.05). Correlation analysis showed that omentin-1 was negatively correlated with the inner diameters of LMCA, LADC and PRCA in CAD group(P＜0.05). Lp-PLA2 was positively correlated with the internal diameters of LMCA, LADC and PRCA(P＜0.05). ROC curve analysis showed that the AUC of serum omentin-1 and Lp-PLA2 in the diagnosis of KD was［0.770(95%CI: 0.635-0.905, P＜0.001), and 0.805(95%CI: 0.685-0.926, P＜0.001)］ respectively, and the sensitivity and specificity were 69.0% vs. 93.7%, and 82.8% vs. 81.2%, respectively. The AUC of serum omentin-1 and Lp-PLA2 in diagnosing coronary artery injury in KD was 0.748(95%CI: 0.612-0.883, P＜0.001) and 0.756(95%CI: 0.619-0.893, P＜0.001), respectively. The sensitivity and specificity were 58.6% vs. 93.9% and 69.0% vs. 88.6%, respectively.
Conclusion  The serum levels of omentin-1 and Lp-PLA2 can be used in the diagnosis of KD disease and the assessment of coronary artery injury in KD children.

Key words: mucocutaneous lymph node syndrome； Omentin-1, lipoprotein associated phospholipase A2

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