基于外周血细胞因子和淋巴细胞表达特征对川崎病发生冠脉损伤影响因素分析 后印本

Краткое изложение: Abstract Objective To observe the expression characteristics of peripheral blood cytokines and lymphocytes in children with Kawasaki disease (KD) and analyze influencing factors related to coronary artery lesions. Methods A total of 50 children with KD who were admitted to the Department of Cardiology of Children's Hospital of Hebei Province from August 2021 to October 2022 were collected. 46 children with simple fever (excluding KD) during the same period were selected as the febrile control (FC) group, and 54 children with normal physical examination were selected. Children were the normal control (NC) group. The expression levels of cytokines and lymphocytes in the peripheral blood of the three groups were detected, and binary Logistic regression analysis was used to analyze the differences between the KD group and the FC group, as well as between the coronary artery lesion(CAL) group and the non-coronary artery lesions (NCAL) group, the receiver operating characteristic curve(ROC) was drawn. Results 1. The levels of IL-4, IL-6, IL-10, IL-5, and IL-8 in the KD group were higher than those in the FC group, and the levels of IL-4, IL-6, IL-10, TNF-α, and IFN-γ, IL-1β, IL-5, IL-12p70, IFN-α, and IL-8 levels were higher than those in the NC group; the levels of IL-4 and IL-1β in the CAL group were higher than those in the NCAL group, while the levels of IL-6 were lower. Both were statistically significant (P<0.05). 2. CD4+T cells and total B cells in the KD group were higher than those in the FC group, while the proportions of total T cells and CD8+T cells were lower; the total B cells in the KD group were higher than those in the NC group, while the proportions of CD8+T cells and NK cells were higher than those in the NC group reduce. NK cells in the CAL group were higher than those in the NCAL group, while the proportion of CD8+ T cells was lower, with statistical differences (P<0.05). 3. Binary Logistic regression showed: (1) Elevation of IL-6 was an independent risk factor for KD, the OR value and 95% confidence interval (95%CI) were 1.071 (1.019, 1.126); (2) CD8+T Cells and NK cells are independent risk factors for CAL, and the OR value and 95%CI are 0.750 (0.611, 0.921) and 1.652 (1.192, 2.289), respectively. Youden index was 0.75, AUC was 0.901, and 95%CI was (0.783, 0.967). Conclusion Elevation of IL-6 is a high-risk factor for the occurrence of KD, and the decrease of CD8+T cells and the increase of NK cells have certain predictive value for the occurrence of CAL in children with KD.