1.The clinical value of plasma N-terminal pro-brain natriuretic peptide and serum albumin in the early diagnosis of incomplete Kawasaki's disease
Yazhen DI ; Ling WU ; Yunyan LI ; Tianrui MA ; Tianbo WANG ; Yahong LIN ; Xiahua DAI
Chinese Journal of Rheumatology 2013;17(9):595-600
Objective To study the expression levels of N-terminal pro-brain natriuretic peptide (NT-proBNP),serum albumin of Kawasaki' s disease (KD),incomplete Kawasaki' s disease (IKD),and children whose fever were unexplained and to explore the clinical significance of the levels of NT-proBNP and serum albumin in the early diagnosis of IKD.Methods The levels of NT-proBNP of 246 cases of KD (KD group),61 cases of IKD (IKD group) and 301 cases of children with unexplained fever (fever group)were measured by the enzyme-linked fluorescence analysis (ELFA) at the day of admission,meanwhile,the levels of albumin were tested in KD,and IKD children were underwent ECG and echocardiography.Based on the test results,patients were further divided into the group with cardiovascular damage and the group without cardiovascular damage.SPSS 19.0 was used for statistical analysis.The t test was used to compare the parameters between each group,the variance analysis and association analysis were carried out with Pearson's correlation analysis.The ROC curve analysis was done to identify the cardiovascular damage threshold.Results ① The level of plasma NT-proBNP of the KD group,the IKD group was significantly h igher than the fever group [(789.1±4.7) ng/L,(824.8±4.4) ng/L vs (92.5±2.3) ng/L,F=230.736,all P<0.05];② The level of albumin of the KD group and the IKD group was significantly lower than that of the fever group [(33.9±2.8) g/L,(33.8±3.1) g/L vs (40.8±3.6) g/L,F=355.648,all P<0.05]; ③ The levels of NT-proBNPs between the cardiovascular damage group and the groups without cardiovascular damage among the KD group,and those of the IKD groups were compared.In the KD group,the NT-proBNPs level of the two subgroups was (2948±3) g/L (n=103) vs (305±3) g/L,n=143; while in the IKD group,the NT-proBNPs of the two subgroups was (1454±4) g/L (n=38) vs (323±4) g/L (n=23).The dif-ferences were statistically significant (t=16.464,4.356,all P<0.05).④ The plasma NT-proBNP level higher than 933.5 ng/L was identify as the indicator for cardiovascular damage in both KD and IKD children.Its sensi-tivity was 88.1%,and its specificity was 89%.⑤ When the level of NT-proBNP was higher than 250 ng/L,the sensitivity for diagnosis in the KD,the IKD was 80.9%,85.2% respec-tively,and the specificity was 85.7%.When the level of NT-proBNP was higher than 250 ng/L and that of albumin was lower than 35 g/L,the sensitivity for diagnosis of KD,IKD was 67.5%,70.5% respectively,the specificity was 99.7%.Conclusion The level of plasma NT-proBNP (>250 ng/L) accompanied by decreased albumin (<35 g/L) may be specific markers for early diagnosis of IKD.In addition,the level of NT-proBNP ≥933.5 ng/L can be used as a diagnostic threshold,which has good sensitivity and specificity for identifica-tion of cardiovascular damage in the KD and IKD in children.
2.Epidemiological analysis of human brucellosis in Ningxia Hui Autonomous Region from 2004 to 2019
Hongju DUAN ; Xianglin WU ; Tianbo MA ; Junling SUN ; Rongting QI ; Fang YAN
Chinese Journal of Endemiology 2022;41(7):580-584
Objective:To learn about the epidemiological characteristics and trends of brucellosis in Ningxia Hui Autonomous Region (Ningxia), and to provide reference for formulation of brucellosis prevention strategies and identification of key areas.Methods:The case data from 2004 to 2019 were collected from the "China Disease Prevention and Control Information System Infectious Disease Monitoring and Reporting System", and descriptive epidemiological methods were used to analyze the distribution of cases (time, population, and regional distribution).Results:From 2004 to 2019, a total of 15 337 human brucellosis cases and 1 death case were reported in Ningxia. The average annual incidence rate was 15.21/100 000, ranging from 0.02/100 000 to 44.83/100 000. The difference in incidence rate in different years was statistically significant (χ 2 = 14 731.60, P < 0.001). Among them, from 2004 to 2010, the incidence rate was low, with an average annual incidence rate of 1.32/100 000; from 2011 to 2019, it entered a high incidence stage, with an average annual incidence rate of 24.83/100 000. Brucellosis occured in every month of the year, and the onset time was mainly in March to September, accounting for 71.60% (10 981/15 337); seasonal indexes from April to August was all > 100%, with obvious seasonality. The age of onset mainly concentrated in 20 - < 70 years old, accounting for 89.60% (13 742/15 337); males were significantly more than females, with a sex ratio of 2.66 ∶ 1.00 (11 141/4 196); the occupations were mainly farmers and herdsmen, accounting for 86.03% (13 194/15 337). Since 2014, cases had been reported in 22 counties (districts, cities) in the region, all of which were all severely endemic areas; the top three counties (districts) with incidence rate were Yanchi County (103.73/100 000), Hongsibao District (56.01/100 000) and Tongxin County (29.18/ 100 000), respectively, the difference between different regions was statistically significant (χ 2 = 3.80, P < 0.001). Conclusions:The incidence rate of brucellosis in Ningxia is on the rise, and the epidemic situation is severe. It is recommended to carry out active and effective intervention measures in areas with high incidence of brucellosis to curb the further spread of brucellosis.