Study On Correlation Between Serum Soluble E Selectin And Coronary Artery Damage In Kawasaki Disease

Objective: Kawasaki disease(KD)is an acute febrile disease characterized by systemic vasculitis.With the progression of the disease,many complications can occur,coronary artery lesions(CAL)is the most common and serious complication.Due to its increasing incidence,KD is currently one of the most common causes of acquired heart disease in children,but its etiology and pathogenesis are still not completely clear,no biological index with high sensitivity and specificity has been found to predict the occurrence of CAL in children with KD.The aim of this study was to analyze the correlation between serum soluble E-selectin(s ES)and KD-CAL and to assess whether s ES can be used as an early sensitive biomarker for predicting the CAL of occurrence in children with KD.Methods:60 cases of KD children hospitalized in the department of pediatrics of the people's hospital of Inner Mongolia autonomous region from October 2015 to October 2019 were selected as the experimental group.There were 22 cases of coronary artery dilatation and 38 cases without coronary artery dilatation.In addition,30 cases of hospitalized children due to infection and fever for more than 5 days and 20 healthy children who underwent physical examination in the outpatient department of pediatrics of our hospital during the same period were selected as the control group.Taking peripheral venous blood in the acute phase of the child's disease(Children with kawasaki disease had their blood drawn before the first use of gamma globulin and anticoagulants).The serum s ES levels of the above three groups were detected and analyzed by sandwich enzyme linked immunosorbent assay(ELISA).Meanwhile,WBC?PLT?HB? CRP?ESR?PCT? ALT and AST were recorded in the KD group.According to the recorded data,SPSS25.0 statistical software was used for statistical analysis.Results: 1.s ES expression can be detected in all the research subjects.2.Serum s ES in healthy control group,fever group,KD group showed an increasing trend of expression,and there was statistical difference between any two groups(P<0.05);s ES level in KD-CAL group was also significantly higher than that in KD-NCAL group(P<0.05).3.The single-factor correlation analysis of s ES?WBC?PLT?HB?CRP?ESR?PCT?ALT?AST and other indicators with the occurrence of CAL in KD children showed that the increased expression levels of WBC?PLT?CRP and s ES were correlated with the occurrence of CAL.Correlation analysis between s ES and the above laboratory indicators showed that serum s ES expression level was positively correlated with PLT?PCT and CRP,and negatively correlated with HB;s ES has no correlation with WBC?ESR?ALT and AST.4.Multivariate and unconditional Logistic regression analysis was performed on the variables with statistical significance between the univariate analysis of the observed indicators and the occurrence of CAL in children with KD,the results showed that in the WBC?PLT?CRP?s ES and other four index of observation,only serum s ES can be used as KD children CAL independent impact factors,the risk of CAL increased by 1.393 times for every 1ng/ml increase in s ES;At the same time,we analyzed the correlation between s ES and the degree of cardiovascular injury,and the results showed that the serum s ES expression level was significantly positively correlated with the severity of coronary artery dilatation.5.Finally,the ROC curve was drawn with s ES concentration as the variable,and the optimal cut-off value for s ES in the diagnosis of CAL in the development of KD was 97.840ng/ml,with a sensitivity of 95.5% and specificity of 92.1%.Conclusions: 1.Serum s ES was expressed in KD group,febrile group and healthy control group.2.Serum s ES can be used as a biological marker of KD,and the more the expression level exceeds the optimal cut-off value,the greater the possibility of CAL.3.Serum s ES showed high sensitivity and specificity for predicting KD combined with CAL.