Clinical Significance Of Platelet Activating Factor And Its Acetylhy Drolase In Kawasaki Disease

Objective: Kawasaki disease(KD)is a systemic vasculitis in children,which is related to inflammation and abnormal activation of immune system.Platelet activating factor(PAF)and its acetylhydrolase(PAF-AH)may play an important role in the pathogenesis of KD.This study aimed to investigate diagnosis and prognostic value of serum PAF and PAF-AH in KD.Methods: 113 KD children were divided into coronary artery lesion(CAL)KD,noncoronary artery lesion(NCAL)KD,intravenous immunoglobulin(IVIG)responsive KD,and IVIG non-responsive KD group.70 cases of fever control(F)group and 71 cases of normal control(N)group were set up.Peripheral venous blood was collected to detect serum PAF and PAF-AH levels,combined with other inflammatory mediators.Results: The serum levels of PAF and PAF-AH were significantly elevated in the KD group compared with F group and N group(P < 0.05).And the levels of conventional inflammatory mediators in KD group were significantly higher than those of F group(P < 0.05).In children with fever(KD group and F group),the area under the receiver operating characteristic curve(AUC)for PAF in prediction of KD was 0.804,and the estimated sensitivity and specificity were 79.6% and 74.3% with a cutoff of PAF >201.77 ng/ml,respectively.The AUC for PAF-AH in prediction of KD was 0.587,and the estimated sensitivity and specificity were 61.9%and 55.7% with a cutoff of PAF-AH > 0.153 ?mol/min/ml,respectively.Compared with NCAL group,PAF and C-reactive protein were higher in CAL group(P < 0.05).The AUC for PAF in prediction of CAL KD was0.679,and the estimated sensitivity and specificity were 96.0% and 40.9%with a cutoff of PAF >225.52 ng/ml,respectively.Conclusion: Serum levels of PAF and PAF-AH were significantly elevated in the acute phase of KD.Serum PAF and PAF-AH contributed to the diagnosis of KD,and serum PAF has a greater diagnostic value for KD.At the same time,elevated serum PAF has a certain predictive value for the occurrence of coronary artery lesions in Kawasaki disease rather than IVIG-nonresponsive KD.