Value of Electrocardiogram QT Interval Dispersion Combined with 25-(OH)D,GDF-15 and PTX3 in the Evaluation of Coronary Artery Lesions in Children with Kawasaki Disease
Objective:To investigate the value of electrocardiogram QT interval dispersion(QTd)combined with 25-hydroxyvita-min D[25-(OH)D],growth differentiation factor-15(GDF-15)and pentraxin 3(PTX3)in the evaluation of coronary artery lesions(CAL)in children with Kawasaki disease.Methods:180 children with Kawasaki disease admitted to our hospital from June 2018 to June 2023 were selected,and patients were divided into CAL group(36 cases)and non-CAL group(144 cases)according to whether CAL occurred.All children received electrocardiogram examination to obtain QTd and corrected QT dispersion(QTcd),and serum 25-(OH)D,GDF-15 and PTX3 levels were detected.The factors affecting the occurrence of CAL in children with Kawasaki disease were analyzed by multi-variate Logistic regression analysis,and a Log P model of multi-index combined application was constructed.The predictive value of QTd,25-(OH)D,GDF-15 and PTX3 for CAL in children with Kawasaki disease were analyzed by receiver operating characteristic(ROC)curve.Results:The levels of QTd,QTcd,GDF-15 and PTX3 in CAL group were higher than those in non-CAL group(P＜0.05),and the level of 25-(OH)D was lower than that in non-CAL group(P＜0.05).Treatment non-response,high QTd,high QTcd,high GDF-15,and high PTX3 were risk factors for CAL in children with Kawasaki disease(P＜0.05),and high 25-(OH)D was a protective factor(P＜0.05).The Log P models of multi-index combined application were constructed as follows:A:electrocardiogram parameter model:Ln(P/1-P)=0.512 × QTd+0.596 QTcd;B:serum 3 index model:Ln(P/1-P)=0.712× GDF-15+0.626× PTX3-0.609× 25-(OH)D;C:5-factor joint application model(above A+B model):Ln(P/1-P)=0.512× QTd+0.596 QTcd+0.712× GDF-15+0.626× PTX3-0.609× 25-(OH)D.ROC analysis showed that,models A,B and C had certain predictive efficacy for CAL in children with Kawasaki disease,and their ROC-AUC(0.95CI)were 0.709(0.490～0.921),0.787(0.579～0.966)and 0.835(0.699～0.955)respectively.C combined application model has the highest prediction efficiency.Conclusion:The QTd increase,QTcd increased,GDF-15 increase,PTX3 increase,and 25-(OH)D decrease in chil-dren with Kawasaki disease with CAL,the combined detection of the above indicators has a high predictive efficiency for the occurrence of CAL in children with Kawasaki disease.
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