To investigate the levels of serum growth differentiation factor-15 (GDF-15), copeptin and myocardial damage markers, and to explore their correlation with myocardial damage in children with herpes angina.

Total of 398 children with herpes angina were collected from January 2016 to January 2019, among whom, 214 children were with herpes simplex angina (control group) and 184 children with herpes angina complicated with myocardial damage (observation group). Peripheral venous blood was collected from all subjects and serum was separated routinely, levels of serum GDF-15, copeptin and marker of myocardial damage cardiac troponinⅠ(cTnⅠ) were measured by ELISA, and levels of serum creatine kinase (CK) and kinase isoenzyme (CK-MB) were measured by DXC600 automatic biochemical analyzer. Pearson correlation analysis was used to analyze the correlations between serum GDF-15, copeptin and CK-MB, cTnⅠ, and Logistic regression analysis was used to analyze the risk factors of myocardial damage in children with herpetic angina. The diagnostic values of serum GDF-15, copeptin, CK-MB and cTnⅠ levels on myocardial damage in children with herpetic pharyngitis were tested by ROC.

There was no significant differences in gender, age and course of disease between cases in observation group and control group (χ² = 0.672, t = 0.585, 0.576; all P > 0.05). Compared with cases in control group, white blood cell (WBC), neutrophile granulocyte (GRAN) and the levels of serum high sensitive C reaction protein (hs-CRP), GDF-15, copeptin, CK, CK-MB and cTnⅠ in observation group increased significantly, while the proportion of abnormal ECG increased significantly (t = 21.237, 18.324, 33.084, 13.535, 17.192, 21.859, 39.014, 24.369, χ² = 28.097; all P < 0.05). Pearson correlation analysis showed that the levels of serum GDF-15, copeptin and CK-MB, cTnⅠ were positively correlated of children of herpes angina complicated with myocardial damage, respectively (r = 0.530, 0.427, 0.443, 0.440; all P < 0.05). Increases of levels of serum GDF-15, copeptin, CK-MB and cTnⅠ were independent risk factors for myocardial damage of children with herpetic angina (all P < 0.05). Serum GDF-15, copeptin, CK-MB and cTnⅠ levels were used to diagnose the myocardial damage of children with herpetic angina, and the area of under curve (AUC) were 0.862, 0.894, 0.886 and 0.973, respectively, and the sensitivity were 81.10%, 84.20%, 85.30% and 90.20%, respectively, the specificity was 79.00%, 81.30%, 91.40% and 94.90%, respectively. The AUC of serum GDF-15 combined with copeptin was 0.953, sensitivity was 94.60% and specificity was 84.10%.

The levels of serum GDF-15 and copeptin of children with herpetic angina were significantly increased, which were positively correlated with levels of CK-MB and cTnⅠ proteins, and were independent risk factors for myocardial damage of children with herpetic angina, which may be of some reference value to diagnose myocardial damage.