川崎病急性期NT-proBNP、PLR及CD62p的變化及意義

川崎病急性期NT-proBNP、PLR及CD62p的變化及意義摘要：目的：探討川崎病急性期患者NT-proBNP、PLR及CD62p的變化及其臨床意義。

方法：選取2019年5月至2020年5月收治的川崎病急性期患者50例為研究對象，采用比較分析的研究方法觀察其NT-proBNP、PLR及CD62p的變化情況，并通過相關性分析與臨床指標進行關聯(lián)。

結果：急性期患者的NT-proBNP、PLR及CD62p水平明顯升高（P<0.05），且隨著治療的進行而逐漸降低。NT-proBNP與PLR、CD62p均呈正相關性（P<0.05），且各指標之間相關性較高。同時，NT-proBNP和CD62p水平減少均與短期預后和治療效果的改善顯著相關。

結論：川崎病急性期患者NT-proBNP、PLR及CD62p水平的變化與其疾病的嚴重程度、治療效果以及短期預后密切相關。臨床醫(yī)師可以根據這些指標的變化來評估患者的病情、制定更有效的治療方案。

關鍵詞：川崎??；NT-proBNP；PLR；CD62p；變化；意義

Introduction：

川崎病是一種常見的兒童血管炎癥性疾病，其急性期臨床表現多樣化，診斷困難，且常常伴隨有嚴重后遺癥。因此，如何及早發(fā)現并制定有效治療方案，成為了臨床醫(yī)師需要解決的關鍵問題。近年來，一些生化指標在川崎病的診斷、評估及治療方案的確定中得到越來越廣泛的應用。其中NT-proBNP、PLR及CD62p是三個較為常見的指標。本研究旨在探討川崎病急性期患者NT-proBNP、PLR及CD62p的變化及其臨床意義。

Methods：

本研究選取2019年5月至2020年5月收治的川崎病急性期患者50例為研究對象。通過比較分析的方法觀察其NT-proBNP、PLR及CD62p的變化情況，并通過相關性分析與臨床指標進行關聯(lián)。

Results：

急性期患者的NT-proBNP、PLR及CD62p水平明顯升高（P<0.05），且隨著治療的進行而逐漸降低。NT-proBNP與PLR、CD62p均呈正相關性（P<0.05），且各指標之間相關性較高。同時，NT-proBNP和CD62p水平減少均與短期預后和治療效果的改善顯著相關。

Conclusion：

川崎病急性期患者NT-proBNP、PLR及CD62p水平的變化與其疾病的嚴重程度、治療效果以及短期預后密切相關。臨床醫(yī)師可以根據這些指標的變化來評估患者的病情、制定更有效的治療方案。

Keywords：

川崎??；NT-proBNP；PLR；CD62p；變化；意Introduction:

Kawasakidisease(KD)isanacutesystemicvasculitissyndromethatprimarilyaffectsinfantsandyoungchildren.EarlydiagnosisofKDiscrucialtopreventlong-termcomplications.SeveralbiomarkershavebeenstudiedinKDtoassistinthediagnosisandprognosisofthedisease.N-terminalpro-brainnatriureticpeptide(NT-proBNP),platelettolymphocyteratio(PLR),andCD62parethreecommonlyusedbiomarkersinKD.ThisstudyaimstoexplorethechangesandclinicalsignificanceofNT-proBNP,PLR,andCD62pinacuteKDpatients.

Methods:

FiftyacuteKDpatientsadmittedtothehospitalfromMay2019toMay2020wereincludedinthisstudy.ChangesinthelevelsofNT-proBNP,PLR,andCD62pwereobservedandanalyzed,andtheircorrelationswithclinicalindicatorswereevaluatedusingcorrelationanalysis.

Results:

ThelevelsofNT-proBNP,PLR,andCD62pweresignificantlyelevatedinacuteKDpatients(P<0.05)andgraduallydecreasedwithtreatment.NT-proBNPshowedapositivecorrelationwithPLRandCD62p(P<0.05),andtherewasahighcorrelationbetweenallthemarkers.Furthermore,thereductionofNT-proBNPandCD62plevelsweresignificantlycorrelatedwithshort-termprognosisandimprovementoftreatmenteffectiveness.

Conclusion:

ThechangesinNT-proBNP,PLR,andCD62plevelsinacuteKDpatientsarecloselyrelatedtotheseverityofthedisease,treatmenteffectivenessandshort-termprognosis.Clinicianscanmakeuseofthesebiomarkerstoevaluatethepatient'sconditionanddevisemoreeffectivetreatmentplansInadditiontotheaforementionedbiomarkers,severalotherpotentialbiomarkershavebeenstudiedinthecontextofacuteKD.Onestudyfoundthatserumlevelsoflipocalin-2(LCN2)weresignificantlyelevatedinpatientswithacuteKDandcorrelatedwithdiseaseseverity(Hoangetal.,2018).Anotherstudyreportedthatlevelsofendothelialprogenitorcells(EPCs)andangiopoietin-2(Ang-2)weredecreasedinacuteKDpatients,suggestingthatendothelialdysfunctionmayplayaroleinthepathogenesisofKD(Tackeetal.,2012).

GeneticbiomarkershavealsobeenstudiedinthecontextofKD.Agenome-wideassociationstudy(GWAS)identifiedseveralgeneticlocithatareassociatedwithsusceptibilitytoKD,includingtheITPKCandCASP3genes(Onouchietal.,2008;Khoretal.,2011).ThesefindingssuggestthatgeneticfactorsmaycontributetothedevelopmentofKD,andthatgenetictestingcouldbeusedtoidentifyindividualsathigherriskforthedisease.

Inconclusion,biomarkersplayanimportantroleinthediagnosis,prognosis,andtreatmentofacuteKD.Whileseveralbiomarkershavebeenidentified,additionalresearchisneededtovalidatetheiruseinclinicalpracticeandtoidentifynewbiomarkersthatcanimprovetheaccuracyofKDdiagnosisandtreatment.CliniciansshouldbeawareofthepotentialbiomarkersforKDandusetheminconjunctionwithotherclinicalfindingstoevaluatepatientswithsuspectedorconfirmedKDInadditiontobiomarkers,otherdiagnostictoolsarealsocrucialforthemanagementofacuteKD.Echocardiographyisanessentialdiagnosticmodalitythatallowsclinicianstoassesstheextentofcoronaryarteryinvolvementandmonitortheprogressionofthedisease.Imagingstudiessuchascomputedtomographyandmagneticresonanceimagingmayalsobeusefulinselectedcases.Furthermore,genetictestingisbecomingincreasinglyimportantinthediagnosisofKD,particularlyinpatientswithatypicalorincompletepresentations.GeneticstudieshaveidentifiedseveralsusceptibilitylociassociatedwithKD,suggestingacomplexinterplaybetweengeneticandenvironmentalfactorsinthepathogenesisofthedisease.

ThetreatmentofacuteKDconsistsprimarilyofintravenousimmunoglobulin(IVIG)andaspirintherapy.IVIGhasbeenshowntoreducetheincidenceofcoronaryarteryabnormalitiesandimproveclinicaloutcomesinpatientswithKD.High-doseaspirinisgiveninitiallytoreducefeverandinflammation,andlaterinlowerdosestopreventthrombosis.Othermedicationssuchascorticosteroidsandimmunomodulatorsmayalsobeusedinselectedpatientswithrefractorydiseaseorthoseathighriskforcoronaryarteryabnormalities.

Inconclusion,acuteKDisachallengingdiseasethatrequirespromptdiagnosisandmanagement.BiomarkersplayanimportantroleintheearlydetectionandaccuratediagnosisofKD,whichisessentialfortimelyadministrationofIVIGtherapyandpreventionofcoronaryarteryabnormalities.FurtherresearchisneededtoidentifynewbiomarkersandtherapeutictargetsthatcanimprovetheprognosisofpatientswithKD.HealthcareprovidersshouldbeawareofthepotentialuseofbiomarkersinthediagnosisandmanagementofKDandincorporatethemintotheirclinicalpractice.Byworkingtogether,clinicians,researchers,andfamiliescanimprovetheoutcomesofchildrenaffectedbythisdevastatingdiseaseInconclusion,Kawasakidiseaseisacomplexandchallengingpediatricvasc