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目的:探讨核细胞核因子-κB(NF-κB)、基质金属蛋白酶9(MMP-9)的表达水平对预测川崎病患儿心血管损害的价值。方法:选取98例被确诊为川崎病的患儿作为川崎病组;选取同期的59例上呼吸道感染患儿作为阳性对照;再选取45例体检健康的正常儿童作为健康对照组,比较三组对象的临床指标并进行ROC曲线分析。结果:三组川崎病患儿的首次应用静脉注射用丙种球蛋白的时间、唇及口腔改变、NF-κB、MMP-9及ALT等水平组间比较差异显著有统计学意义(F=4.56,P=0.000;F=1.63,P=0.014;F=6.12,P=0.000;F=7.78,P=0.000;F=5.99,P=0.000)。心血管损害组的61例川崎病患儿的年龄、首次应用静脉注射用丙种球蛋白的时间、NF-κB、MMP-9、HDL-C及ALT等水平与心血管无损害组的37例患儿比较差异显著有统计学意义(t=4.986,P=0.000;t=5.736,P=0.000;t=33.705,P=0.000;t=54.355,P=0.000;t=66.292,P=0.000;t=11.581,P=0.000)。当NF-κB≥788.5 ng·L~(-1)时,鉴别是否发生心血管损害的敏感性达88.2%,特异性达85.6%;当MMP-9≥696.5 ng·L~(-1)时,鉴别是否发生心血管损害的敏感性达87.5%,特异性达86.8%。当NF-κB的诊断临界点788.5 ng·L~(-1)≥且MMP-9≥696.5 ng·L~(-1)时,鉴别是否发生心血管损害的特异性达92.0%。结论:NF-κB、MMP-9的表达水平在川崎病患儿心血管损害中可起到对心血管损害有效预测的价值。
Objective: To investigate the value of nuclear factor-κB (NF-κB) and matrix metalloproteinase-9 (MMP-9) expression in predicting cardiovascular damage in children with Kawasaki disease. Methods: Ninety-eight children with Kawasaki disease who were diagnosed as Kawasaki disease were selected as the Kawasaki disease group. Fifty-nine children with upper respiratory tract infection during the same period were selected as the positive control. Forty-five healthy children were selected as the healthy control group. The clinical indicators and ROC curve analysis. Results: The first application of three groups of children with Kawasaki disease intravenous gamma globulin time, lip and oral changes, NF-κB, MMP-9 and ALT levels were significantly different (P = 4.56, P = 0.000; F = 1.63, P = 0.014; F = 6.12, P = 0.000; F = 7.78, P = 0.000; F = 5.99, P = 0.000). Sixty-one children with Kawasaki disease in cardiovascular impairment group were included in this study. The age, the first application of intravenous gamma globulin, NF-κB, MMP-9, HDL-C and ALT were compared with those in 37 The difference was statistically significant (t = 4.986, P = 0.000; t = 5.736, P = 0.000; t = 33.705, P = 0.000; t = 54.355, P = 0.000; t = 66.292, P = 0.000; t = 11.581, P = 0.000). When NF-κB≥788.5 ng · L -1, the sensitivity and specificity of differentiating into cardiovascular damage were 88.2% and 85.6% respectively. When MMP-9≥696.5 ng · L -1 , Identify whether the occurrence of cardiovascular damage sensitivity of 87.5%, specificity of 86.8%. When the diagnostic threshold of NF-κB was 788.5 ng · L -1 and MMP-9 was greater than or equal to 696.5 ng · L -1, the specificity of detecting cardiovascular damage was 92.0%. Conclusion: The expression of NF-κB and MMP-9 may play an important role in the prediction of cardiovascular damage in children with Kawasaki disease.