Evaluation And Diagnostic Value Of Peripheral Blood T Lymphocyte Subsets And Immunoglobulin Levels In The Occurrence And Development Of Kawasaki Disease

Kawasaki Disease,also known as Mucocutaneous Lymph Node Syndrome(MCLS),An acute febrile and rash childhood disease characterized by systemic vasculitis.The main symptoms are fever,extremity changes,perianal molting,rash,bulbous conjunctival congestion,mucous membrane changes,lymph node enlargement,and mental and emotional reactions.The disease is more common in infants,more for boys than girls.At present,the etiology of this disease is unknown,and it is generally believed that it may be associated with infection of streptococcus,mycoplasma and other pathogens.It is a kind of immune mediated systemic vasculitis triggered by a variety of infectious pathogens in a certain susceptible host.There is certain difficulty in early diagnosis,especially for Incomplete Kawasaki Disease,due to the complexity and heterogeneity of Kawasaki Disease,broad differential diagnosis and the lack of specific laboratory diagnostic gold standard.Studies have found that children with Kawasaki disease who are accurately diagnosed and receive regular treatment can recover in about 7 weeks without sequelae.Only a small number of children may have cardiac complications,and the recurrence rate is low.It can be concluded that early and accurate diagnosis of Kawasaki Disease is of critical significance for the later curative effect,the prevention of coronary artery disease and the prognosis of children.Studies have shown that cellular immunity and humoral immunity of children with Kawasaki Disease are abnormal,for they are in an immune imbalance.Early detection of T lymphocyte subgroup and immunoglobulin level,contributes to an understanding of patient’s cellular immune function and humoral immune function,but it is not yet clear about the role of these factors in the occurrence and development of Kawasaki Disease,and their diagnostic value as well as therapeutic value to combat Kawasaki Disease are also not yet known.Objective:To investigate the diagnostic value of T lymphocyte subgroup and immunoglobulin levels in peripheral blood in curing Kawasaki disease.Methods:A total of 63 children with Kawasaki Disease(observation group)and60 children with infectious fever(control group)were selected from the pediatric department of our hospital from December 2018 to February 2021.All of the patients,before being injected with gamma globulin in vein,receiced venous blood sample collection before treatment.We used flow cytometry to detect lymphocyte subgroup immune classification.We also used Multi TEST automated software to count the absolute value of lymphocyte subsets and conduct a relative percentage content analysis.The levels of IgG,IgM and IgA in peripheral blood of all patients were detected by rate scattering turbidimetric method.Results:1,The control group and observation group with serum WBC levels of10.01±4.58(x10~9/L),and 15.88±4.66x10~9/L),with statistically significant difference(P<0.05);The control group’s serum CRP level was 23.18±8.72(mg/L),significantly lower than the obervation group’s 52.71±8.72(mg/L)(P<0.05);The control group serum PCT level was 0.27±0.11(ng/L),significantly lower than the observation group level’s 1.93±0.12(ng/L)(P<0.05).The areas under ROC curve of WBC,CRP and PCT for Kawasaki Disease diagnosis were 0.754,0.871 and 0.899,respectively.2,The observation group with peripheral blood CD3~+T cells and CD8~+T cells were significantly lower than the control group,in the absolute value,with statistically meaningful difference(P<0.05);There was no meaningful difference in the absolute value of CD4~+T cells between the two groups(P>0.05).The observation group’s peripheral blood CD4~+/CD8~+ratios and NK cells were significantly higher than that of the control group,with statistically meaningful difference(P<0.05).3,The observation group’s percentage of CD3~+T cells and percentage of CD8~+T cell have statistically meaningful differences(P<0.05),and the percentage of CD4~+T cells in the observation group was significantly higher than that of the control group(P<0.05);The areas under the curve of the ROC of NK cells and CD4~+/CD8~+ratios for diagnosis of Kawasaki Disease,were 0.624 and 0.876.4,Observation group’s IgG,IgA levels were significantly lower than that of the control group,with a statistically meaningful difference(P<0.05);There was no significant difference in IgM and levels between the two groups(P>0.05);The areas under the ROC curve of IgG,IgM and IgA for Kawasaki Disease diagnosis were 0.681,0.654 and 0.672,respectively.Conclusions:1.Among the serum inflammatory indicators of the children with Kawasaki disease,the levels of serum WBC,CRP and PCT have significant diagnostic value for Kawasaki disease.2,In the peripheral blood lymphocyte subsets of children with kawasaki disease,NK cells and CD4~+/CD8~+ratios can be used in the diagnosis of Kawasaki Disease,and the diagnosis efficiency is higher;3,For children with Kawasaki Disease,in their immune globulin,IgG and IgA levels have high application value in the diagnosis of Kawasaki Disease and diagnosis efficiency is higher.