关键词: 肺炎支原体, 川崎病, 心肌功能, 脂蛋白磷脂酶A2, N-末端脑利钠肽原, 降钙素原, 凝血指标

Abstract:

Objective　To investigate the relationship between myocardial function and serum levels of lipoprotein-associated phospholipase A2 (Lp-PLA2), N-terminal pro B-type natriuretic peptide (NT-proBNP), procalcitonin (PCT), and coagulation indicators in children with Kawasaki disease (KD) complicated by mycoplasma pneumoniae (MP) infection. Methods　Eighty children with KD who were admitted to Yan'an University Affiliated Hospital from January 2020 to January 2024 were selected as the study subjects. The MP infection status of the children was detected, and they were grouped accordingly. 31 children with MP infection were included in the infection group, while the remaining 49 children were included in the non-infection group. There were 18 boys and 13 girls in the infection group, aged (3.16±1.22) years. There were 29 boys and 20 girls in the non-infection group, aged (3.72±1.45) years. The clinical data (age, maximum body temperature, duration of fever, conjunctival congestion, dry lips, strawberry tongue, oral mucosa congestion, trunk rashes, limb erythema, limb edema, skin peeling at fingertips, perianal peeling, cervical lymph node enlargement) and laboratory indicators (creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, α-hydroxybutyrate dehydrogenase, aspartate aminotransferase, NT-proBNP, Lp-PLA2, PCT, prothrombin time, activated partial thromboplastin time, fibrinogen quantification, clotting time, antithrombin Ⅲ, D-dimer) were compared between the two groups. Independent sample t test and χ² test were used for statistical analysis. Pearson correlation analysis was used to investigate the relationship between myocardial function and serum levels of Lp-PLA2, NT-proBNP, PCT, and coagulation indicators. Results　Comparison of the clinical data between the two groups showed no statistically significant differences (all P>0.05). The comparisons of the levels of creatine kinase, lactate dehydrogenase, α-hydroxybutyrate dehydrogenase, and aspartate aminotransferase between the two groups showed no statistically significant differences (all P>0.05); the level of creatine kinase isoenzyme in the infection group was higher than that in the non-infection group [(42.88±5.78) U/L vs. (30.88±7.12) U/L] (P<0.05). There was no statistically significant difference in the levels of serum NT-proBNP between the two groups (P>0.05); the levels of serum Lp-PLA2 and PCT in the infection group were higher than those in the non-infection group [(543.80±121.12) μg/L vs. (466.15±116.15) μg/L, (0.88±0.21) μg/L vs. (0.44±0.15) μg/L] (both P<0.05). There was no statistically significant difference in the comparisons of prothrombin time, activated partial thromboplastin time, fibrinogen quantification, clotting time, and antithrombin Ⅲ level between the two groups (all P>0.05); the D-dimer level in the infection group was higher than that in the non-infection group [(855.12±124.41) μg/L vs. (744.15±110.15) μg/L] (P<0.05). The Pearson correlation analysis showed that the level of creatine kinase isoenzyme was positively correlated with serum levels of Lp-PLA2, PCT, and D-dimer, the level of α-hydroxybutyrate dehydrogenase was positively correlated with the level of serum NT-proBNP, and the level of aspartate aminotransferase was positively correlated with the level of serum PCT (all P<0.05). Conclusion　Children with KD combined with MP infection have more severe impairment of myocardial function, and it also affects the inflammatory response and coagulation function of the children. Specifically, the levels of creatine kinase isoenzyme, serum Lp-PLA2, PCT, and D-dimer increase. There is a positive correlation between myocardial enzymes and inflammatory and coagulation function indicators.

Key words: Mycoplasma pneumoniae,  , Kawasaki disease,  , Myocardial function,  , Lipoprotein-associated phospholipase A2,  , N-terminal pro B-type natriuretic peptide,  , Procalcitonin,  , Coagulation indicators