Predictive Value Of Kininogen 1 And Arginase 1 For Coronary Artery Lesion In Kawasaki Disease

Objectives:To observe the changes of Kininogen1(KNG1)and Arginase1(Arg1)levels in peripheral blood of children with Kawasaki disease(KD),and to explore the predictive value of KNG1 and Arg1 for coronary artery lesion in Kawasaki disease.Methods:A retrospective study.A total of 117 children with KD admitted to Shenzhen Children’s Hospital of China Medical University from December 2020 to December 2021were selected.[Coronary artery lesion(CAL)group(n=53),Non-coronary artery lesion(NCAL)group(n=64)].The clinical data of all KD children were collected,including age,gender,clinical classification,Intravenous immunoglobulin(IVIG),days of fever,echocardiography results(Z score)during the course of the disease,total bilirubin,Aspartate aminotransferase(AST),Alanine aminotransferase(ALT),White blood cell(WBC),Proportion of neutrophils(N%),Proportion of lymphocyte(L%),Platelet(PLT),Hemoglobin(Hb),C-reactive protein(CRP),Procalcitonin(PCT),Erythrocyte sedimentation rate(ESR),Albumin(ALB),Sodium(Na~+).Peripheral venous blood samples were collected from KD children at admission(before IVIG treatment),and serum KNG1 and Arg1 levels were measured by ELISA.SPSS 23.0 software was used to analyze the data.Results:1.There was no significant difference in age,clinical classification and IVIG efficacy between CAL group and NCAL group(P>0.05).There was a significant difference in sex ratio between the CAL group and the NCAL group.The proportion of females in the CAL group was lower than that in the NCAL group,and the proportion of males was higher than that in the NCAL group(P<0.05).2.There were no significant differences in the levels of total bilirubin,ALT,WBC,L%,Hb,CRP,PCT and Na~+ between CAL group and NCAL group(P>0.05).The days of fever and PLT level in the NCAL group were lower than those in the CAL group,and the differences were statistically significant(P<0.05).The levels of AST,N%,ALB and ESR in CAL group were lower than those in NCAL group,and the differences were statistically significant(P<0.05).3.The levels of KNG1 and Arg1 in CAL group were significantly higher than those in NCAL group,and the differences were statistically significant(P<0.001).4.Multivariate Logistic regression analysis showed that KNG1,Arg1 and N%were independent risk factors for complication of CAL in KD patients.ROC curve analysis showed that the best predictive value of KNG1 for CAL was 1.536ng/ml,the area under the curve was 0.823(95%CI:0.750-0.896),the sensitivity was 67.9%,the specificity was82.8%,and the Youden index was 0.507.The best predictive value of Arg1 for CAL was7.028ng/ml,the area under the curve was 0.862(95%CI:0.792-0.931),the sensitivity was 77.4%,the specificity was 89.1%,and the Youden index was 0.665.The best predictive value of N%for CAL was 54.7%,the area under the curve was 0.610(95%CI:0.507-0.712),the sensitivity was 54.7%,the specificity was 65.6%,and the Youden index was 0.203.When the three indicators were combined to predict the occurrence of CAL,the area under the curve was 0.929(95%CI:0.881-0.977),the sensitivity and specificity of predicting CAL were 84.9%and 92.2%,respectively,and the Youden index was 0.771.Conclusions:1.Peripheral blood KNG1 and Arg1 can be used as auxiliary predictors of CAL in KD;2.The combination of KNG1,Arg1 and N%can significantly improve the clinical predictive value of KD complicated with CAL.