AST/ALT与川崎病患儿静脉注射丙种球蛋白无反应及冠状动脉损伤的相关性

doi:10.3969/j.issn.1671-7171.2023.06.009

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Abstract 【Objective】 To investigate the relationship between Aspartate transaminase (AST)/alanine aminotransferase (ALT) and non response of intravenous immunoglobulin and coronary artery lesion (CAL) in children with Kawasaki disease (KD). 【Methods】 A total of 218 children with KD admitted to Xianyang Rainbow Hospital from June 2018 to May 2021 were selected. According to the treatment status of IVIG,the children were divided into a sensitive group (those who were initially effective in IVIG) and a non responsive group (those who were unresponsive to IVIG treatment). AST,ALT,and AST/ALT were compared between the two groups. KD patients were divided into occurrence and non occurrence groups based on whether they experienced CAL. The influencing factors for the occurrence of CAL in KD patients were analyzed,and the efficacy of AST/ALT in predicting the occurrence of CAL in KD patients was evaluated using the receiver operating characteristic (ROC) curve. 【Results】 The ALT level in the unresponsive group was higher than that in the sensitive group,while AST/ALT was lower than that in the sensitive group,with a statistically significant difference (P<0.05). After 8 weeks of treatment,the incidence of CAL in KD patients was 22.48% (49/218). The duration of fever before IVIG treatment,the ratio of IVIG unresponsive types,PCT,ALT in the occurrence group were higher than those in the non occurrence group (P<0.05),while AST/ALT was lower than those in the non occurrence group (P<0.05). The results of multivariate logistic analysis showed that IVIG treatment without response,ALT,and AST/ALT were all influencing factors for the occurrence of CAL in children with KD (P<0.05). The Receiver operating characteristic analysis showed that the best cut-off point for AST/ALT to assess the incidence of CAL in KD children was 0.63,and the sensitivity,specificity and AUC were 83.67%,68.05% and 0.803,respectively. 【Conclusion】 ALT is higher in IVIG unresponsive KD patients,while AST/ALT is lower. AST/ALT has a higher clinical value in predicting the occurrence of CAL in KD patients.

Key words： Mucocutaneous Lymph Node Syndrome Alanine Transaminase/BL Aspartate Aminotransferases/BL Immunoglobulins/TU Coronary Artery Disease

Received: 21 November 2022

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R725

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	GUO Xiao-jun
	GAO Dong-lian

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GUO Xiao-jun,GAO Dong-lian. The Correlation between AST/ALT and Unresponsiveness to Intravenous Immunoglobulin and Coronary Artery Lesion in Children with Kawasaki Disease[J]. JOURNAL OF CLINICAL RESEARCH, 2023, 40(6): 830-833.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2023.06.009 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2023/V40/I6/830

[1] RIFE E,GEDALIA A. Kawasaki disease:an update[J].Curr Rheumatol Rep,2020,22(10):75-79.
[2] QIAN B,HUANG H,CHENG M,et al. Mechanism of HMGB1-RAGE in kawasaki disease with coronary artery injury[J].Eur J Med Res,2020,25(1):8-10.
[3] 陶治洲. 血清天冬氨酸氨基转移酶、丙氨酸氨基转移酶比值测定在肝病中的诊断价值[J].医药卫生,2016,15(8):206-207.
[4] EWID M,SHERIF H,ALLIHIMY A S,et al. AST/ALT ratio predicts the functional severity of chronic heart failure with reduced left ventricular ejection fraction[J].BMC Res Notes,2020,13(1):178.
[5] 王永清,曹晓军. 静脉注射丙种球蛋白无反应性川崎病的诊治现状[J].中华儿科杂志,2005,43(3):226-228.
[6] LIU X,ZHOU K,HUA Y,et al. Grisel's syndrome in Kawasaki disease[J].Orphanet J Rare Dis,2020,15(1):246.
[7] 闵丽,袁时健,刘亚红,等. 川崎病患儿血浆YKL-40、CRP、IL-6对急性期冠状动脉损伤的诊断价值[J].疑难病杂志,2023,22(4):367-372.
[8] 王程浩,梁雪村,储晨,等. 川崎病所致严重冠状动脉病变单中心队列研究[J].中国循证儿科杂志,2023,18(1):32-36.
[9] 叶军红,陈烨,朱香兰. IVIG联合泼尼松预防严重KD患儿冠脉损害可行性分析[J].中国妇幼健康研究,2019,30(1):77-81.
[10] 李诗雨,丁艳. 静脉注射免疫球蛋白无反应型川崎病患儿血清白细胞介素-17A的表达及临床意义[J].中国当代儿科杂志,2023,25(3):244-249.
[11] QIU H,LI C,HE Y,et al. Association between left ventricular ejection fraction and Kawasaki disease shock syndrome[J].Cardiol Young,2019,29(2):178-184.
[12] ZHANG H,LIU T,LI C,et al. Effect of moderate activity on liver function and serum lipid level in healthy subjects during the phase I clinical trial[J].Expert Opin Drug Metab Toxicol,2020,16(12):1217-1221.
[13] SCHEIPNER L,SMOLLE M A,BARTH D,et al. The AST/ALT ratio is an independent prognostic marker for disease-free survival in stage Ⅱ and Ⅲ colorectal carcinoma[J].Anticancer Res,2021,41(1):429-436.