| Objective: To investigate the correlation and diagnostic value of serum Prealbumin(PA),Cystatin C(Cys-C)and Coronary artery lesion(CAL)in children with Kawasaki disease(KD).Methods: The clinical data(including sex and age)of 124 children with KD and 56 healthy children admitted to the Department of Pediatrics,Chaohu Hospital affiliated to Anhui Medical University from January 2017 to February 2022 were analyzed retrospectively,they were divided into KD Group(N = 124)and control group(N = 56).In addition,children with KD were divided into two groups based on echocardiography diagnosis: coronary artery lesion group(CAL group,N = 41)and non-coronary artery lesion group(NCAL group,N = 83),serum levels of PA,alanine aminotransferase(ALT),aspartate aspartate transaminase(AST),Cys-C,blood urea nitrogen(BUN)and creatinine(Cr)were compared between the groups.The relationship between PA,Cys-C and CAL in children with KD was analyzed by binary Logistic regression,and the Receiver Operator Characteristic(ROC)curve of serum PA,Cys-C and combined detection was drawn,the clinical diagnostic value of Area Under the Curve(AUC)and different boundary points were analyzed.Results:1、There was no significant difference in age and sex between KD group and control group(P > 0.05).In addition,there was no significant difference in age and sex between CAL group and NCAL group(P > 0.05).2、The serum levels of PA and BUN in KD group were lower than those in control group,and the levels of Cys-C were higher than those in control group(P < 0.05).There was no significant difference in ALT、AST and Cr between the two groups(P > 0.05).3、The serum levels of PA and Cys-C in CAL group were significantly lower than those in NCAL group(P < 0.05),and the serum levels of Cys-C in CAL group were significantly higher than those in NCAL group(P < 0.05).There was no significant difference in ALT、AST,BUN and Cr between the two groups(P> 0.05).4、According to binary Logistic regression analysis,PA(OR = 0.976,P = 0.019)、Cys-C(OR = 2.150,P < 0.01),PA and Cys-C were correlated with CAL in KD.Cys-C was an independent risk factor for CAL in KD,PA is a protective factor.The ROC curves of PA and Cys-C were drawn according to the experimental results.When the cut-off value of PA was 70.5 mg/L,the sensitivity was 0.756,the specificity was 0.663,and the 95% Confidence interval(CI)was 0.790-0.919(P< 0.05).When the cut off value for Cys-C was chosen as 0.815 mg/L,the sensitivity was 85.4%,the specificity was 74.7%,and the 95% CI was 0.790-0.919(P< 0.05).The area under AUC curve of PA,Cys-C and combined detection were 0.741,0.855 and 0.869,respectively.The sensitivity and specificity were 75.6% and 86.7% respectively.5、Analysis of the differences in the area under the curve of PA,Cys-C and combined testing of the two to predict combined CAL in children with KD showed that the diagnostic value of Cys-C was higher than that of PA when PA was compared with Cys-C alone,and the difference was statistically significant(P<0.05).Analysis of the difference in the area under the curve between the combined PA and both tests for predicting combined CAL in children with KD showed that the predictive efficacy of the combined test was higher than that of the PA test alone,and the difference was statistically significant(P<0.05).Analysis of the difference in the area under the curve between Cys-C and the two combined tests for predicting combined CAL in children with KD showed that the difference was not statistically significant(P>0.05).Conclusion:PA and Cys-C were correlated with Kawasaki disease combined with coronary artery lesions.Cys-C was an independent risk factor for coronary artery damage and PA was a protective factor.PA and Cys-C had predictive significance for Kawasaki disease combined with coronary artery damage,and Cys-C had greater predictive significance than PA detection. |
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