Abstract: Objective　To study the expression levels of N-terminal B-type brain natriuretic peptide (NT-proBNP), procalcitonin (PCT), and interleukin-6 (IL-6) in serum of 0-6 months old infants with Kawasaki disease (KD) and their clinical significance. Methods　A total of 72 children with KD hospitalized in Children's Hospital Affiliated to Zhengzhou University from January 1, 2018 to December 31, 2020 were selected and were divided into a typical group (32 cases) and an atypical group (40 cases) according to the clinical manifestations and signs. And 30 non-KD children hospitalized with fever during the same period were selected as a control group. The level of NT-proBNP in serum was determined by electrochemiluminescence method, the level of PCT in serum was determined by immunofluorescence quantitative method, and the level of IL-6 in serum was determined by enzyme-linked immunosorbent assay. The changes of NT-proBNP, IL-6, and PCT in KD children were observed after intravenous injection of human gamma globulin. χ² test, one-way analysis of variance, Mann-Whitney U test, and Kruskal-Wallis H test were used. Results　The level of serum NT-proBNP in the control group was 537.25 (392.39, 724.95) pg/ml, which was lower than those in the typical group and the atypical group [1 340.00 (924.50, 3 050.00) pg/ml and 927.90 (585.50, 1 499.50) pg/ml], with statistically significant differences (both P<0.05), but there was no statistically significant difference between the typical group and the atypical group (P>0.05). The level of serum IL-6 in the control group was 24.90 (14.75, 33.13) pg/ml, which was lower than those in the typical group and the atypical group [98.07 (83.56, 151.15) pg/ml and 72.28 (55.35, 114.30) pg/ml], with statistically significant differences (both P<0.05), but there was no statistically significant difference between the typical group and the atypical group (P>0.05). There were statistically significant differences in the PCT level among the control group [0.96 (0.55, 2.13) μg/L], the atypical group [(0.24 (0.14, 0.50) μg/L], and the typical group [0.40 (0.29, 0.74) μg/L], with statistically significant differences (all P<0.05). After treatment, the levels of NT-proBNP and IL-6 in children with KD decreased compared with those before treatment [365.10 (205.73, 736.35) pg/ml vs. 1 168.50 (773.95, 1 972.25) pg/ml, 15.55 (5.83, 46.32) pg/ml vs. 91.70 (69.24, 136.67) pg/ml], with statistically significant differences (both P<0.05). There was no statistically significant difference in the level of PCT between before and after treatment [0.12 (0.07, 0.25) μg/L vs. 0.33 (0.17, 0.58) μg/L] (P>0.05). Conclusion　NT-proBNP, IL-6, and PCT can be used as important reference indexes for the diagnosis of KD in infants aged 0-6 months in the early stage of the disease.

Key words: N-terminal brain natriuretic peptide precursor, Interleukin-6, Procalcitonin, Kawasaki disease

摘要： 目的　研究0～6月龄婴儿川崎病（Kawasaki disease，KD）血清中N末端B型脑钠肽原（NT-proBNP）、降钙素原（PCT）、白细胞介素-6（IL-6）表达水平及临床意义。方法　收集2018年1月1日至2020年12月31日郑州大学附属儿童医院收治KD患儿72例，根据临床表现及体征分为典型组（32例）和不典型组（40例），并选取同期因发热住院治疗非KD患儿为对照组（30例）。典型组患儿男20例，女12例，月龄（2.7±0.2）个月；不典型组患儿男23例，女17例，月龄（2.9±0.1）个月；对照组患儿男17例，女13例，月龄（2.9±0.3）个月。应用电化学发光法检测血清中NT-proBNP水平，应用免疫荧光定量法检测血清中PCT水平，应用酶联免疫吸附法检测血清中IL-6水平。KD患儿使用静注人丙种球蛋白后比较NT-proBNP、IL-6、PCT的变化。采用χ²检验、单因素方差分析、Mann-Whitney U检验、Kruskal-wallis H检验。结果　对照组患儿血清NT-proBNP水平537.25（392.39，724.95）pg/ml低于典型组1 340.00（924.50，3 050.00）pg/ml和不典型组927.90（585.50，1 499.50）pg/ml，差异均有统计学意义（均P<0.05），典型组和不典型组相比差异无统计学意义（P>0.05）。对照组患儿血清IL-6水平24.90（14.75，33.13）pg/ml低于典型组98.07（83.56，151.15）pg/ml和不典型组72.28（55.35，114.30）pg/ml，差异均有统计学意义（均P<0.05），典型组和不典型组相比差异无统计学意义（P>0.05）。对照组患儿PCT水平0.96（0.55，2.13）μg/L与不典型组0.24（0.14，0.50）μg/L、典型组0.40（0.29，0.74）μg/L比较，差异均有统计学意义（均P<0.05）。治疗后KD患儿NT-proBNP、IL-6水平较治疗前NT-proBNP、IL-6下降［365.10（205.73，736.35）pg/ml比1 168.50（773.95，1 972.25）pg/ml，15.55（5.83，46.32）pg/ml比91.70（69.24，136.67）pg/ml］，差异均有统计学意义（均P<0.05）；治疗后患儿PCT水平与治疗前比较差异无统计学意义［0.12（0.07，0.25）μg/L比0.33（0.17，0.58）μg/L］（P>0.05）。结论　NT-proBNP、IL-6、PCT疾病前期联合检测可作为辅助诊断0～6月龄小婴儿KD的重要参考指标。

关键词: N末端脑钠肽前体, 白细胞介素-6, 降钙素原, 川崎病