Clinical Study Of Platelet Microparticles And Activated Platelet Membrane Protein Receptor In Kawasaki Disease

Objective:The aim of this study is to investigate the levels of microparticlesPMPs,(CD41+)and activated platelet membrane protein specific receptor(PAC-1)in Kawasaki disease,and to compare the differences of PMPs and PAC-1 at different stages of KD.Moreover,we try to analyze the correlation between PMPs,PAC-1 and coronary artery lesions in children with KD at different stages.Methods:We assigned 27 patients hospitalized in Children’s Hospital of Soochow University from March 2016 to August 2016 with a diagnosis of KD as the research object,27 children with respiratory tract infection were selected as febrile group and 27 healthy children were selected as healthy control group study.Blood routine test was routinely analyzed in the acute stage,subacute stage and convalescent stage in KD patients.The absolute number of PMPs and activation ratio of PAC-1 was determined by flow cytometry.The clinical data were compared among the different groups,and the correlation between PMPs and PAC-1,Blood platelet count(BPC)and CRP was analyzed.The absolute number of PMPs and the activation ratio of PAC-1 were compared between the two groups of KD patients with coronary artery lesions(CAL)and the non coronary lesion(nCAL)group.1.KD patients in subacute stage had significant lower levels of peripheral blood neutrophil percentage(N%),white blood cell count(WBC),mean platelet volume(MPV),C reactive protein(CRP)than in acute stage(P <0.05).KD patients in subacute stage had significant higher levels of blood platelet count(BPC)than in acute stage(P <0.05).There were no significant differences in hemoglobin(HB),erythrocyte sedimentation rate(ESR)and hematocrit(HCT)between the acute and subacute stages of KD(P >0.05).2.KD patients in both acute and subacute stage had significant higher levels of PMPs absolute number than febrile groups(P <0.05)and healthy control group(P <0.05).The absolute number of PMPs in the convalescent stage was significantly higher than that inthe healthy control group(P <0.05).There was no significant difference in the absolute number of PMPs in the convalescent stage of KD patients and the febrile group(P >0.05).3.KD patients in both acute and subacute stage had significant higher levels of PMPs absolute number than in the convalescent stage(P <0.05).In the subacute stage,the absolute PMPs number reached the peak,which was significantly higher than that in the acute stage(P <0.05).4.KD patients in both acute and subacute stage had significant higher levels of PAC-1activation ratio than febrile groups(P <0.05)and healthy control group(P <0.05).The PAC-1 activation ratio in the recovery stage was significantly higher than that in the healthy control group(P <0.05).There was no significant difference in PAC-1 activation ratio in the convalescent stage of KD patients and the febrile group(P <0.05).5.KD patients in both acute and subacute stage had significant higher levels of PAC-1activation ratio than in the convalescent stage(P <0.05).In the subacute stage,the PAC-1activation ratio reached the peak,which was significantly higher than that in the acute stage(P <0.05).6.In the acute stage and convalescent stage of KD,PMPs absolute number and PAC-1activation ratio between CAL and nCAL groups were not statistically significant(P > 0.05).In the subacute stage,the absolute number of PMPs and the activation rate of PAC-1 in CAL group were significantly higher than those in nCAL group(P <0.05).7.PMPs were positively correlated with PAC-1,PMPs were positively correlated with blood platelet count and in the acute stage,and PMPs were positively correlated with CRP.Conclusion:1.The level of PMPs and activated ratio of PAC-1 were significantly higher than the controls,indicating roles of PMPs and PAC-1 in the pathogenesis of KD.2.PMPs and PAC-1 not only can be used as a marker of disease progression,but also related with the occurrence of CAL,which can be used as an indicator of the prognosis of patients.3.PMPs were higher in the subacute stage than in the acute stage,indicating a stronger procoagulant activity than PLT.Thus,we should pay more attention to the anticoagulant therapy in KD.