Li Dan, Zhang Wenjing, Feng Huiqing, Li Man, Zhao Jing, Xu Yanpeng, Liu Yanping
Department of Cardiology, Baoding Hospital of Beijing Children's Hospital Capital Medical University 3399 Hengxiang North Street, Lianchi District, Baoding 071000, Hebei, China.
Am J Transl Res. 2025 May 15;17(5):3683-3690. doi: 10.62347/AJMB5384. eCollection 2025.
To investigate the association between N-terminal pro-brain natriuretic peptide (NT-proBNP), interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), and coronary artery injury in children with Kawasaki disease (KD).
This retrospective study included 42 children with KD admitted to Baoding Hospital of Beijing Children's Hospital Capital Medical University from January 2019 to January 2022 (KD group), and 80 healthy children during the same period (control group). Peripheral blood markers including white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hb), hematocrit (HCT), mean platelet volume (MPV), platelet distribution width (PDW), platelet count (PLT), NT-proBNP, IFN-γ, TNF-α, C-reactive protein (CRP), and circulating endothelial cell count (CEC) were compared between groups. KD patients were further stratified based on the severity of coronary artery involvement for subgroup analysis.
Compared with the control group, the KD group showed significantly higher levels of WBC, PDW, PLT, NT-proBNP, IFN-γ, TNF-α, CRP, and CEC, and significantly lower levels of RBC, Hb, and HCT (all P < 0.05). MPV levels did not differ significantly between groups (P > 0.05). Among the 42 KD patients, 17 had coronary artery involvement. These patients exhibited significantly higher levels of PDW, NT-proBNP, IFN-γ, TNF-α, CRP, and CEC compared to those without coronary artery injury (all P < 0.05). There were no significant differences in WBC, RBC, Hb, HCT, MPV, or PLT between the KD subgroups with and without coronary artery lesions (all P > 0.05). The diagnostic sensitivity of NT-proBNP, IFN-γ, and TNF-α for coronary artery injury in KD was 96.18%, 83.47%, and 65.20%, respectively, with specificities of 78.71%, 82.16%, and 81.98%, respectively. The area under the ROC curve for NT-proBNP, IFN-γ, and TNF-α was 0.969, 0.875, and 0.704, respectively. Logistic regression analysis identified elevated IFN-γ, TNF-α, CRP, and CEC as independent risk factors for coronary artery injury in children with KD (all P < 0.05).
NT-proBNP, IFN-γ, and TNF-α levels are significantly elevated in children with severe KD and are closely associated with coronary artery injury. These biomarkers may serve as early predictors of coronary artery complications in KD.
探讨N端前脑钠肽（NT-proBNP）、干扰素-γ（IFN-γ）、肿瘤坏死因子-α（TNF-α）与川崎病（KD）患儿冠状动脉损伤之间的关联。
本回顾性研究纳入了2019年1月至2022年1月在首都医科大学附属北京儿童医院保定医院收治的42例KD患儿（KD组），以及同期80例健康儿童（对照组）。比较两组外周血标志物，包括白细胞计数（WBC）、红细胞计数（RBC）、血红蛋白（Hb）、血细胞比容（HCT）、平均血小板体积（MPV）、血小板分布宽度（PDW）、血小板计数（PLT）、NT-proBNP、IFN-γ、TNF-α、C反应蛋白（CRP）和循环内皮细胞计数（CEC）。KD患者根据冠状动脉受累严重程度进一步分层进行亚组分析。
与对照组相比，KD组WBC、PDW、PLT、NT-proBNP、IFN-γ、TNF-α、CRP和CEC水平显著升高，RBC、Hb和HCT水平显著降低（均P<0.05）。两组间MPV水平差异无统计学意义（P>0.05）。42例KD患者中，17例有冠状动脉受累。与无冠状动脉损伤的患者相比，这些患者的PDW、NT-proBNP、IFN-γ、TNF-α、CRP和CEC水平显著升高（均P<0.05）。有和无冠状动脉病变的KD亚组之间WBC、RBC、Hb、HCT、MPV或PLT无显著差异（均P>0.05）。NT-proBNP、IFN-γ和TNF-α对KD冠状动脉损伤的诊断敏感性分别为96.18%、83.47%和65.20%，特异性分别为78.71%、82.16%和81.98%。NT-proBNP、IFN-γ和TNF-α的ROC曲线下面积分别为0.969、0.875和0.704。Logistic回归分析确定IFN-γ、TNF-α、CRP和CEC升高是KD患儿冠状动脉损伤的独立危险因素（均P<0.05）。
重症KD患儿NT-proBNP、IFN-γ和TNF-α水平显著升高，且与冠状动脉损伤密切相关。这些生物标志物可能作为KD冠状动脉并发症的早期预测指标。
