Abstract:

Objective　 To investigate the relationships between peripheral blood miR-233-3p, miR-145, and NLRP3 inflammasome and coronary artery lesions (CAL) in children with Kawasaki disease (KD). Methods　The general data of 96 children with KD treated in Children's Hospital Affiliated to Zhengzhou University from November 2021 to December 2022 were retrospectively analyzed. All the children underwent cardiac color ultrasound examination after admission. According to the KD related diagnostic criteria proposed by the American Heart Association in 2017, 96 children with KD were divided into a CAL group (32 cases) and a non-CAL group (64 cases). The general data [gender, age, body mass index (BMI), fever time, etc.] and peripheral blood miR-233-3p, miR-145, and NLRP3 inflammasome levels were compared between the two groups. The multivariate logistic regression analysis was used to analyze the independent factors affecting the occurrence of CAL in KD children, and the assessment model of risk was established. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficiency of the model. Independent sample t test and χ² test were used. Results　In the CAL group, there were 18 boys and 14 girls, aged (3.63±0.54) years, with body mass index of (13.77±2.06) kg/m² and duration of fever of (5.41±0.81) d. In the non-CAL group, there were 35 boys and 29 girls, aged (3.58±0.53) years, with body mass index of (13.82±2.07) kg/m² and duration of fever of (5.36±0.80) d, with no statistically significant difference (all P>0.05). The levels of miR-233-3p and NLRP3 in the CAL group were higher than those in the non-CAL group [(1.28±0.19) vs. (0.93±0.13), (5.44±0.81) vs. (3.63±0.54)], but the level of miR-145 was lower than that in the non-CAL group [(1.07±0.16) vs. (1.98±0.29)], with statistically significant differences (t=10.606, 13.027, and 16.510, all P<0.001). Multivariate analysis by logistic regression model showed that miR-233-3p (OR=7.338, P=0.023), miR-145 (OR=0.590, P=0.001), and NLRP3 inflammasome (OR=3.111, P=0.012) levels were independent influencing factors for the occurrence of CAL in KD children. According to the ROC analysis, the area under the curve (AUC) value of miR-233-3p, miR-145, and NLRP3 combined detection mode was the highest, which was 0.899, and the sensitivity and specificity were 93.75% and 90.62%, respectively. Conclusions　miR-233-3p, miR-145, and NLRP3 inflammasome in peripheral blood of children with KD are closely related to the occurrence of CAL. Among them, the levels of miR-233-3p, miR-145, and NLRP3 inflammasome play an important role in the occurrence of CAL in KD children, and the combined detection of miR-233-3p, miR-145, and NLRP3 inflammasome has high clinical application value in evaluating the occurrence of CAL in KD children.

Key words:

Kawasaki disease, Coronary artery lesions, miR-233-3p, miR-145, NLRP3 inflammasome, Children

摘要：

目的　探讨川崎病患儿外周血miR-233-3p、miR-145及NLRP3炎症小体与其冠状动脉损害（CAL）的关系。方法　回顾性分析2021年11月至2022年12月郑州大学附属儿童医院收治的96例川崎病患儿一般资料。患儿入院后均进行心脏彩超检查，根据2017年美国心脏学会提出的川崎病相关诊断标准，将96例川崎病患儿分为CAL组（32例）和非CAL组（64例）。比较两组一般资料（性别、年龄、体重指数、发热时间等）及外周血miR-233-3p、miR-145、NLRP3炎症小体水平。通过多因素logistic回归分析影响川崎病患儿发生CAL的独立因素，建立风险评估模型，经受试者操作特征曲线（ROC）评估模型诊断效能。采用独立样本t检验、χ²检验。结果　CAL组男18例，女14例，年龄（3.63±0.54）岁，体重指数（13.77±2.06）kg/m²，发热天数（5.41±0.81）d；非CAL组男35例，女29例，年龄（3.58±0.53）岁，体重指数（13.82±2.07）kg/m²，发热天数（5.36±0.80）d，差异均无统计学意义（均P>0.05）。CAL组miR-233-3p、NLRP3水平均高于非CAL组［（1.28±0.19）比（0.93±0.13）、（5.44±0.81）比（3.63±0.54）］，miR-145水平低于非CAL组［（1.07±0.16）比（1.98±0.29）］，差异均有统计学意义（t=10.606、13.027、16.510，均P<0.001）；经logistic回归模型多因素分析，miR-233-3p（OR=7.338，P=0.023）、miR-145（OR=0.590，P=0.001）、NLRP3炎症小体（OR=3.111，P=0.012）水平均是川崎病患儿发生CAL的独立影响因素；由ROC分析，miR-233-3p、miR-145、NLRP3炎症小体水平联合检测模式下的曲线下面积（AUC）值最高，为0.899，且灵敏度、特异度分别为93.75%、90.62%。结论　川崎病患儿外周血miR-233-3p、miR-145、NLRP3炎症小体与CAL的发生有紧密关联。其中miR-233-3p、miR-145、NLRP3炎症小体水平均是川崎病患儿伴发CAL的独立影响因素，同时通过miR-233-3p、miR-145、NLRP3炎症小体表达联合检测的方式在评估川崎病患儿发生CAL方面具有较高的临床应用价值。

关键词:

川崎病, 冠状动脉损害, miR-233-3p, miR-145, NLRP3炎症小体, 儿童