心型脂肪酸结合蛋白及冠状动脉Z值在川崎病早期诊断的临床意义

中国中西医结合儿科学 ›› 2021, Vol. 13 ›› Issue (1): 58-.

心型脂肪酸结合蛋白及冠状动脉Z值在川崎病早期诊断的临床意义

陈强，赵海燕，訾慧芬，候毅，杨雯，宋天月

014040 内蒙古包头，包头市中心医院儿科

出版日期:2021-02-25 发布日期:2021-05-17
通讯作者: 赵海燕，E-mail：chenqiang55010@sina.com
作者简介:陈强（1976-），男，医学硕士，主任医师。研究方向：儿童重症的救治
基金资助:
包头市科技计划项目（2019Z3009-7）

Clinical significance of hearttype fatty acid binding protein and Z value of coronary artery in early diagnosis of Kawasaki disease

CHEN Qiang, ZHAO Haiyan, ZI Huifen, HOU Yi, YANG Wen, SONG Tianyue

Baotou Central Hospital，Baotou 014040,China

Online:2021-02-25 Published:2021-05-17

摘要/Abstract

摘要： 目的：观察川崎病患儿心型脂肪酸结合蛋白(h-FABP)、冠状动脉Z值的变化情况对小儿川崎病早期诊断的临床意义。
方法：选择2018年10月至2020年8月于内蒙古自治区包头市中心医院收治并确诊为川崎病患儿50例为观察组，同期收治并确诊为上呼吸道感染患儿55例为对照组，收集入选川崎病患儿急性期、恢复期及上呼吸道感染患儿入院时的hFABP及冠状动脉Z值，进行统计学分析。
结果：观察组急性期hFABP水平高于对照组，差异有统计学意义（P<0.05）；观察组恢复期hFABP水平与对照组比较差异无统计学意义（P>0.05）；观察组急性期h-FABP水平明显高于恢复期，差异有统计学意义（P<0.05）。观察组急性期左冠状动脉(LCA)Z值与左前降支(LAD)Z值显著高于对照组，差异有统计学意义（P<0.05）。观察组急性期右冠状动脉(RCA)Z值、恢复期RCA-Z值、LCA-Z值与LAD-Z值与对照组比较差异无统计学意义（P>0.05）。h-FABP水平与RCA、LCA及LAD均无相关性（P>0.05）。线性回归分析表明RCA、LCA及LAD线性均不能影响h-ABP的水平（P>0.5）。
结论：（1）川崎病患儿会出现h-ABP升高，对于早期诊断川崎病或不典型川崎病提供一定依据。（2）川崎病恢复期患儿h-ABP明显低于川崎病急性期，能尽早评估川崎病患儿心肌有无受损。（3）川崎病患儿早期可出现冠状动脉扩张，且极易引起LCA及LAD的扩张，对于早期诊断川崎病或不典型川崎病提供一定临床依据。（4）如果能在川崎病诊断标准中加入h-ABP水平且结合冠状动脉Z值，可能会更早发现及确诊川崎病，尤其对不典型川崎病的诊断会有很大帮助。

关键词: 川崎病, 心型脂肪酸结合蛋白, 冠状动脉, Z值, 儿童

Abstract: Objective：To study the clinical significance of heart-ype fatty acid binding protein (h-ABP) and coronary artery Z value in early diagnosis of Kawasaki Disease in children.
Methods：From October 2018 to August 2020, 50 children with Kawasaki disease were confirmed and treated in Baotou Central Hospital of Inner Mongolia Autonomous Region, who were included as the observation group, and 55 children with respiratory tract infection were included as the control group. The h-ABP and coronary artery Z value of children with Kawasaki disease in the acute and recovery period were collected, and the h-ABP and coronary artery Z value of children with respiratory tract infection on admission was collected, and they were analyzed statistically.
Results：The h-ABP level in acute stage of observation group was higher than that of control group, there being statistical difference(P<0.05); there was no statistical difference in h-BP level in convalenscence stage between observation group and control group (P>0.05); the h-ABP level of observation group was significantly higher in acute stage than in convalescence stage(P<0.05). The Z value of left coronary artery(LCA) and left anterior descending branch(LAD) in acute stage of observation group was significantly higher than that of control group(P<0.05). There was no statistical difference between observation group and control group in the Z value of right coronary artery(RCA) in acute stage, the RCA- value in convalenscence stage, LCA- value or LAD- value(P>0.05). There was no relationship between h-ABP level and RCA, LCA or LAD(P>0.05). Linear regression analysis showed that RCA, LCA and LAD couldn't affect h-ABP level(P>0.05)
Conclusion：（1）There is an increase of h-ABP in children with Kawasaki disease, which may provide a basis for the early diagnosis of Kawasaki disease or atypical Kawasaki disease. （2）The level of h-P in convalescence stage in children with Kawasaki disease was significantly lower than that in acute stage, which can be used to evaluate whether there is myocardial damage in children with Kawasaki disease as early as possible. （3）The dilation of coronary artery can occur in the early stage of Kawasaki disease, and is most likely to cause LCA and LAD dilation, which can provide some clinical basis for the early diagnosis of Kawasaki disease or atypical Kawasaki disease. （4）If the level of h-BP can be added into the diagnosis standard of Kawasaki disease and combined with the Z value of coronary artery, Kawasaki disease may be found and confirmed earlier, especially atypical Kawasaki disease.

Key words: Heart-ype fatty acid binding protein, Coronary arteries, Z value, Kawasaki disease

陈强，赵海燕，訾慧芬，候毅，杨雯，宋天月. 心型脂肪酸结合蛋白及冠状动脉Z值在川崎病早期诊断的临床意义[J]. 中国中西医结合儿科学, 2021, 13(1): 58-.

CHEN Qiang, ZHAO Haiyan, ZI Huifen, HOU Yi, YANG Wen, SONG Tianyue. Clinical significance of hearttype fatty acid binding protein and Z value of coronary artery in early diagnosis of Kawasaki disease[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2021, 13(1): 58-.

[1]	王雪峰, 尚云晓. 儿童流行性感冒中西医结合防治专家共识[J]. 中国中西医结合儿科学, 2021, 13(5): 369-.
[2]	吕楠, 万凯, 李靖婕, 马彩云, 尚清. 前庭训练结合运动学分析法对运动发育迟缓患儿康复疗效影响的临床研究[J]. 中国中西医结合儿科学, 2021, 13(5): 395-.
[3]	牛震丙, 刘静, 冯利利. β2-微球蛋白与中性粒细胞明胶酶相关脂质运载蛋白联合检测在传染性单核细胞增多症患儿早期肾损伤的价值分析[J]. 中国中西医结合儿科学, 2021, 13(5): 399-.
[4]	罗兰, 刘萍萍, 方思思. 脓毒症患儿急性期的静息能量代谢研究[J]. 中国中西医结合儿科学, 2021, 13(5): 405-.
[5]	唐小利, 邓红波. 回顾性分析23例百日咳患儿的临床特点[J]. 中国中西医结合儿科学, 2021, 13(5): 416-.
[6]	徐莎. 匹多莫德联合维生素AD治疗小儿反复呼吸道感染的效果观察[J]. 中国中西医结合儿科学, 2021, 13(5): 421-.
[7]	解莹. 反复呼吸道感染住院患儿危险因素回顾性调查[J]. 中国中西医结合儿科学, 2021, 13(5): 425-.
[8]	张俊清, 郭亮, 师灿南, 王军. 河南省婴儿死亡率和5岁以下儿童死亡率变化及预测分析[J]. 中国中西医结合儿科学, 2021, 13(5): 428-.
[9]	杜琳麟, 汪永红, 和婧伟. 小儿咳嗽用药规律研究[J]. 中国中西医结合儿科学, 2021, 13(5): 431-.
[10]	杜芙俐, 代晓愉, 郑亚蓓, 郑宏. 基于中医时间医学探讨儿童矮身材的治疗思路[J]. 中国中西医结合儿科学, 2021, 13(5): 454-.
[11]	刘克新, 郑英, 张雪利, 刘桃桃, 李家华, 彭燕容. 热敏灸治疗肺炎喘嗽恢复期肺脾气虚型80例临床观察[J]. 中国中西医结合儿科学, 2021, 13(5): 458-.
[12]	王圣楠, 王国杰, 王海. 苇茎涤痰汤治疗儿童迁延性细菌性支气管炎疗效观察[J]. 中国中西医结合儿科学, 2021, 13(4): 281-.
[13]	韩晶, 徐炎, 孙丽平. 槐杞黄颗粒在儿科的临床应用研究进展[J]. 中国中西医结合儿科学, 2021, 13(4): 292-.
[14]	王诗妍, 马丙祥, 李瑞星, 徐萍萍. 儿童抽动障碍研究进展[J]. 中国中西医结合儿科学, 2021, 13(4): 297-.
[15]	袁检仔, 张莉, 袁业红, 马淑霞. 中医辨治小儿上气道咳嗽综合征研究进展[J]. 中国中西医结合儿科学, 2021, 13(4): 301-.