| Objective: To explore the expression level of galectin-9(Gal-9)in serum of children with Kawasaki disease(KD)and its clinical value.Methods: Forty children with KD who were hospitalized in Wuhan Children’s Hospital from December 2021 to October 2022 were selected as the KD group.They were divided into KD group before and after gamma globulin treatment(IVIG).The positive control group selected 20 children with fever(excluding KD and other immune diseases)in the same period,referred to as the infection group.The negative control group selected 20 children with health examination in our hospital in the same period,referred to as the normal group.The clinical data of all study subjects were collected,the serum levels of Gal-9,IL-6,IL-17,and TGF-β1 in each group were detected by ELISA,and the relevant statistical analysis was performed.SPSS 26.0 was used for statistical analysis.Mean ± standard deviation( ± )were used to statistically describe the measurement data,frequencies(%)were used to statistically describe the enumeration data,t-test was used to compare the mean values between the two groups,analysis of variance was used to compare the means of the three groups and above,Person analysis was used for correlation.Multivariate regression analysis and ROC curve were also used to analyze the diagnostic value and prognostic value of Gal-9for KD.Results:1.Comparison of general data of each group: There was no statistical difference in gender and age composition among the groups(P > 0.05).2.Comparison of the levels of important inflammatory factors in children of each group:(1)The levels of IL-6 and IL-17 in KD before treatment were higher than those in infection group and normal group,and IL-6 and IL-17 showed a decreasing trend after IVIG treatment in KD(P < 0.05).(2)Compared with the normal group,the infected group,and the KD pretreatment group,the TGF-β1 level in the serum of the KD treatment increased(P < 0.05).3.Comparison of Gal-9 levels in children of each group:(1)Serum Gal-9 levels were higher in KD before treatment and in the infected group than in the normal group(P < 0.05).(2)Levels of Gal-9 in serum before KD treatment were lower than those in serum after KD treatment(P < 0.05).4.Correlation analysis and regression analysis of serum Gal-9 levels and important inflammatory factors : correlation analysis showed that there was a negative correlation between Gal-9 levels and IL-6,and a positive correlation with TGF-β1(P < 0.05);regression analysis showed that there was a linear dependence between Gal-9 and TGF-β1(P < 0.05).5.Multiple linear regression analysis of the association between Gal-9 levels and KD: After adjusting for age,sex and common infection-induced fever,multiple linear regression analysis showed that Gal-9 levels showed an independent positive correlation with the incidence of KD(β= 2.32,95% CI: 0.68 ～ 3.961,P = 0.007).6.Predicting the diagnostic value of Gal-9 level for KD with ROC curve: When the Gal-9value ≥10.225 pg/ml,the area under the ROC curve reached the maximum AUC = 0.739,95% CI(0.576 ～ 0.901),P = 0.01,corresponding to a sensitivity of 85% and a specificity of65%.7.Multivariate regression analysis was used to investigate the prognostic value of Gal-9levels in KD: After adjusting for confounding factors such as age,sex,and important inflammatory factors IL-6,IL-17,and TGF-β,the changes in the levels of Gal-9 before and after KD treatment were very significant(β=4.32,95% CI:1.91 ～ 6.71,P = 0.001),indicating that Gal-9 was independently associated with the outcome after KD treatment..Conclusion:1.Gal-9 may be involved in the occurrence and development of KD and is expected to be a new inflammatory marker of KD.2.Gal-9 has a strong diagnostic value in KD. |
