| ObjectiveThis study was to observe the changes of serum N-terminal pro-brain natriuretic peptide(NT-pro BNP),red blood cell distribution width(RDW)and serum amyloid A(SAA)levels in children with Kawasaki disease(KD),and to explore their predictive value in Kawasaki disease complicated with coronary artery injury,so as to provide more basis for the diagnosis and treatment of Kawasaki disease,to reduce the incidence of complications of Kawasaki disease.MethodsA retrospective study was conducted.80 children with Kawasaki disease who were first diagnosed as Kawasaki disease in the Department of internal medicine of Shenyang children’s Hospital from September 2020 to December 2022 were selected as the research object,and were classified as Kawasaki disease group.According to the results of echocardiography in the color Doppler room of our hospital,they were further divided into coronary artery dilation(CAD)(n=21)and non coronary artery dilation(NCAD)(n=59);At the same time,20 healthy children who underwent physical examination in the outpatient department of child protection in our hospital were selected as the healthy control group.The general data of children in Kawasaki disease group and healthy control group,the laboratory test results of children in Kawasaki disease group before treatment in the acute phase and healthy children in the healthy control group,and the echocardiography results of children with Kawasaki disease during hospitalization and within 2 months follow-up period were collected.Then observing the changes of various indicators between Kawasaki disease group and healthy control group,as well as between coronary artery expansion group and non coronary artery expansion group.Using the data statistics software of IBM SPSS 22.0,the general data and laboratory results of each group were statistically analyzed,and the differences of various indicators between Kawasaki disease group and healthy control group,coronary artery expansion group and non coronary artery expansion group were compared.According to the data of patients,the influencing factors of CAL were analyzed by logistic multivariate analysis.The receiver operating curve(ROC)was drawn to analyze the predictive effectiveness of various indicators on the risk of CAL.Results1.Comparing the levels of NT-pro BNP,RDW and SAA between Kawasaki disease group and healthy control group,the differences of NT-pro BNP and SAA levels between the two groups were statistically significant(Z=-6.86,P<0.001;Z=-6.894,P<0.001);There was no significant difference in RDW between the two groups(Z=-3.71,P=0.711).2.Comparing the levels of NT-pro BNP,RDW and SAA between coronary artery expansion group and non coronary artery expansion group,the levels of NT-pro BNP and SAA in the coronary artery expansion group were higher than those in the non coronary artery expansion group(Z=-5.779,P<0.001;Z=-3.396,P=0.001);There was no significant difference in RDW between the two groups(Z=-0.837,P=0.402).3.Children in the Kawasaki dissease group clasified by whether combined with CAD were used as the depentent variable,and NT-pro BNP and SAA as the covariates,a multivariate binary logistic regression study was conducted.The results showed that NT Pro BNP and SAA were independent risk factors for CAD in children with KD.4.Receiver operating characteristic curve(ROC)was used to analyze the predictive ability of NT-pro BNP,SAA,RDW for CAD in Kawasaki disease.The area under the curve(AUC)of RDW value,SAA value and NT-pro BNP value were 0.562,0.751 and0.927,respectively.The optimal cut-off points of each index were 12.15,198.85 and493.65,respectively.At this time,the sensitivity was 1.000,0.857 and 0.905,respectively,and the specificity was 0.288,0.542,and 0.831,respectively.Conclusions1.NT-pro BNP and SAA have certain predictive value for Kawasaki disease complicated with coronary artery dilatation.2.RDW has little predictive value for coronary artery dilatation in children with Kawasaki disease. |
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