Changes And Significance Of N-terminal Pro-BNP,PLR And CD62p In The Acute Phase Of Kawasaki Disease

Objective:We analyzed the changes of NT-pro BNP,Platelet-to-lymphocyte ratio（PLR）and CD62 p in the acute phase of Kawasaki disease（KD）to investigate the clinical value of NT-pro BNP,PLR and CD62 p in the acute phase of KD.Methods:60 children in the acute phrase of KD in Provincial Children’s Hospital Affiliated to Anhui Medical University from December 2020 to May 2021 were considered as KD group,while the other 30 children with fever not caused by KD and 30 healthy children were selected as control groups and their age were similar to KD group ’s.Blood specimens were collected from children in the KD group and fever control group before treatment,and from children in the healthy control group on the day of healthy physical examination.The levels of NT-pro BNP in all subjects were measuered by colloidal gold method,and the levels of CD62 p in all subjects were measuered by flow cytometry.Moreover,the differences in levels of NT-pro BNP,PLR,CD62 p and blood routine-related indexes in 3 groups were compared,Correlation of NT-pro BNP,PLR,and CD62 p with other routine-related blood indicators was also analyzed.In addition,Changes in NT-pro BNP,PLR and CD62 p levels in KD with and without comorbid mitral regurgitation,coronary artery lesions,liver lesions,IVIG insensitivity and other symptoms were compared.The diagnostic significance for KD and Predicting the value for KD combined with CAL of NT-pro BNP,PLR and CD62 p were also investigated.Results:Levels of NT-pro BNP,PLR and CD62 p in KD group were higher than fever group and healthy group（P<0.05）.The levels of NT-pro BNP in patients with IVIG-resistant and coronary artery lesion（CAL）were significantly higher than that in IVIG-responsive and without CAL（NCAL）（all P<0.05）.The CD62 p level was significantly higher in patients with IVIG-resistant and coronary artery lesion（CAL）than that in IVIG-responsive and without CAL（NCAL）（all P<0.05）.NT-pro BNP levels were correlated with CRP positively（r=0.406,P<0.05）and left ventricular enddiastolic diameter（LVDD）（r=0.22,P<0.05）,while negatively correlated with HB（r=-0.426,P<0.05）and albumin levels（r=-0.406,P<0.05）.The PLR level was positively correlated with left ventricular internal dimension systole（LVDS）（r=0.271,P<0.05）,but negatively correlated with the WBC（r=-0.287,P<0.05）.The CD62 p level was positively correlated with CRP（r=0.421,P<0.05）,NT-pro BNP（r=0.998,p<0.05）and left ventricular enddiastolic diameter（LVDD）（r=0.22,P<0.05）Area under the receiver operating curve of NT-pro BNP,PLR and CD62 p in dignosis of KD were0.916（95%CI:0.859-0.973,P<0.05）,0.692（95%CI:0.595-0.788,P<0.05）and1.000（95%CI:1.000-1.000,P<0.05）respectively.The area under the ROC curves with NT-pro BNP and CD62 p to predict CAL was 0.890（95%CI:0.831-0.949,P<0.05）and0.786（95%CI:0.707-0.865,P<0.05）respectively.Conclusion:NT-pro BNP,PLR and CD62 p are helpful to early diagnosis of KD.Platelets are highly activated in children with acute KD,indicating that platelet activation may be involved in the pathophysiology of Kawasaki disease.NT-pro BNP and CD62 P have predictive value for the development of IVIG-resistant and CAL.