血清ANGPTL8、ITLN-1对川崎病患儿冠状动脉损伤的预测价值OACSTPCD

Objective To explore the predictive value of serum angiopoietin-like protein 8(ANGPTL8)and intelectin-1(ITLN-1)in coronary artery injury in children with Kawasaki disease(KD).Methods A total of 108 children with KD who were admitted to our hospital from May 2020 to May 2023 were regarded as the study group,they were divided into coronary artery injury group(n=37)and non-coronary artery injury group(n=71)according to the occurrence of coronary artery injury;another 72 healthy children who underwent physical examination were regarded as the control group.Double-antibody sandwich enzyme-linked immunosorbent assay was applied to detect serum inflammation related markers and levels of ANGPTL8 and ITLN-1 in all subjects.Pearson's method was applied to analyze the correlation between serum levels of ANGPTL8,ITLN-1 and inflammatory markers in KD patients with coronary artery injury.The predictive value of serum ANGPTL8 and ITLN-1 levels for coronary artery injury in children with KD was evaluated.Results In the coronary artery injury group,KD children had significantly higher levels of platelet(PLT),C-reaction protein(CRP),interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-α)compared to the non-coronary artery injury group(F/X2=67.198,75.056,71.876 and 94.158,respectively,all P＜0.05);compared with the control group,KD children in the study group showed a significant increase in serum ANGPTL8 levels(t=17.490,P＜0.05),and a significant decrease in ITLN-1 levels(t=13.162,P＜0.05);compared with the non-coronary artery injury group,KD children in the coronary artery injury group exhibited a significant increase in serum ANGPTL8 levels(t=7.454,P＜0.05)and a significant decrease in ITLN-1 levels(t=7.631,P＜0.05).The results of pearson correlation analysis showed that in KD children with coronary artery injury,serum levels of ANGPTL8 were positively correlated with PLT,CRP,IL-6 and TNF-α levels(r=0.514,0.638,0.484 and 0.674,respectively,P＜0.05),while the ITLN-1 levels were negatively correlated with PLT,CRP,IL-6 and TNF-α levels(r=-0.603,-0.659,-0.439 and-0.646,respectively,P＜0.05).The results of receiver operating characteristic(ROC)curve analysis showed that the combined prediction of serum ANGPTL8 and ITLN-1 for coronary artery injury in KD children had an area under the curve(AUC)of 0.950,with a sensitivity of 89.19% and a specificity of 85.91% .The results of multivariate logistic regression analysis showed that elevated levels of PLT,CRP,IL-6,TNF-α and ANGPTL8 were independent risk factors for coronary artery injury in children with KD,while an elevated level of ITLN-1 was a protective factor for coronary artery injury in children with KD.The OR values and 95% CI were as follows:1.623(1.088-2.421)for PLT,1.722(1.266-2.342)for CRP,1.413(1.035-1.930)for IL-6,1.725(1.210-2.460)for TNF-α,1.534(1.114-2.111)for ANGPTL8,and 0.685(0.485-0.967)for ITLN-1.Conclusion The serum levels of ANGPTL8 in KD children with coronary artery injury are obviously increased,while the level of ITLN-1 is obviously decreased.The independent risk factors for coronary artery injury in KD children include elevated levels of ANGPTL8 and decreased levels of ITLN-1.The combined assessment of their serum levels holds a high predictive value for coronary artery injury in children with KD.