| ObjectiveTo study the severity and susceptibility of Coronary Artery Lesions and NT-pro BNP,s B7-H3,CRP in children with Kawasaki diseaseMethodsFrom January 2017 to June 2021,412 KD children with KD patients with echocardiographic data in our hospital were selected as the research subjects and set as the KD group;meanwhile,age-and gender-matched non-KD fever(pneumonia and fever time >5 days)were selected.Thirty children with fever time>5 days were set as the fever control group;30 healthy children who were matched for age and sex during the same period were set as the healthy control group.The levels of NT-pro BNP,s B7-H3,CRP,and T lymphocytes were detected,and the above indicators were compared in each group.412 children with Kawasaki disease were divided into groups according to the occurrence of coronary artery damage and the severity of the damage,and the levels of NT-pro BNP,s B7-H3 and CRP in each group were compared.The degree of arterial damage was the dependent variable.Multinomial classification Logistic model was used to analyze the effect of different NT-pro BNP,s B7-H3 and CRP levels on the occurrence of coronary artery damage in children with Kawasaki disease.All the children were followed up regularly in outpatient clinics,and the recovery time of coronary artery disease(CAL)was recorded,and the correlation between the levels of NT-pro BNP,s B7-H3,CRP and CAL recovery was analyzed.Results1.CAL occurred in 103 of 412 KD children,accounting for 25%,of which 84.47% occurred within 1-2 weeks.CAL returned to normal in 1 month in 7 cases,accounting for 6.80%,in 2 months in 9 cases,accounting for 8.74%,in 3 months in 12 cases,accounting for 11.65%,and in 6 months in 23 cases,accounting for 22.33%,12 cases 21 cases returned to normal after 12 months,accounting for 20.39%;29 cases did not return to normal after 12 months of follow-up,accounting for 28.16%,and 2 cases were lost to follow-up.2.There were significant differences in the levels of s B7-H3,NT-pro BNP and CRP in the Kawasaki disease CAL group,Kawasaki disease non-CAL group,fever control group and healthy control group(P<0.05).Pairwise comparison between groups: the levels of s B7-H3 in the CAL group and non-CAL group were(361.82±35.84)pg/m L and(519.34±52.79)pg/m L,respectively,which were lower than those in the fever control group and the healthy control group(619.83±59.88)pg/m L,(621.07±47.32)pg/m L;s B7-H3 level in CAL group was lower than non-CAL group;NT-pro BNP level in Kawasaki disease CAL group and non-CAL group was(318.74±22.17)pg/m L,(234.58± 16.72)pg/m L,which were higher than(188.60±14.25)pg/m L and(172.55±5.93)pg/m L of the fever control group and healthy control group;the NT-pro BNP level in the CAL group was higher than that in the non-CAL group;the CAL group,non-CAL group The CRP levels in the group were(82.35±10.47)mg/L and(53.16±4.82)mg/L,which were higher than(12.96±1.92)mg/L and(0.93±0.0)mg/L of the fever control group and the healthy control group.;CRP level in CAL group was higher than that in non-CAL group;the difference was statistically significant(P<0.05).There were significant differences in the proportion of CD3+,CD8+,CD19+ cells and the ratio of CD4+/CD8+ in the CAL group,non-CAL group,fever control group and healthy control group(P<0.05). Pairwise comparison between groups: the ratio of CD19+ cells and the ratio of CD4+/CD8+ in the CAL group and the non-CAL group were higher than those in the fever control group and the healthy control group;the ratio of CD19+ cells and the ratio of CD4+/CD8+ in the CAL group were higher than those in the non-CAL group;the CAL group and the non-CAL group were higher than those in the non-CAL group.The proportions of CD3+ and CD8+ cells were lower than those in the fever control group and the healthy control group;the proportions of CD3+ and CD8+ cells in the CAL group were lower than those in the non-CAL group;the differences were statistically significant(P<0.05).3.There were significant differences in the levels of s B7-H3,NT-pro BNP and CRP among the non-CAL group,mild CAL group,moderate CAL group and severe CAL group(P<0.05).Pairwise comparison between groups: the level of s B7-H3 in the severe CAL group was(282.59±25.07)pg/m L,which was lower than(329.66±34.36)pg/m L in the moderate CAL group.The levels were lower than those in the mild CAL group(393.57±36.11)pg/m L,and the levels of s B7-H3 in the severe CAL group,moderate CAL group and mild CAL group were all lower than those in the non-CAL group(519.34±52.79)pg The levels of NT-pro BNP and CRP in the severe CAL group were(402.81±28.64)pg/m L and(102.88±12.33)mg/L,respectively,which were higher than those in the moderate CAL group(362.75±22.83)pg/m L and(91.57)±10.86)mg/L,the levels of NT-pro BNP and CRP in the severe CAL group and moderate CAL group were higher than those in the mild CAL group(294.57 ± 20.48)pg/m L,(70.49 ± 8.59)mg/L,and the severe CAL group,The levels of NT-pro BNP and CRP in the moderate CAL group and the mild CAL group were higher than those in the non-CAL group(234.58±16.72)pg/m L and(53.16±4.82)mg/L,and the differences were statistically significant(P<0.05).4.Logistic regression analysis showed that when s B7-H3 ≥ 426.29 pg/m L,the susceptibility to CAL in children with KD was extremely low,and when s B7-H3 < 429.29 pg/m L,the susceptibility to CAL in children with KD increased,and the lower the level of s B7-H3,the higher the susceptibility to CAL.Children with KD had higher susceptibility to CAL(317.25 pg/m L≤s B7-H3 <426.29 pg/m L and <317.25 pg/m L OR values were 2.870 and 4.202,respectively;95%CI: 1.908-5.173,2.163-7.091).When NT-pro BNP<272.33 pg/m L,KD children had a very low susceptibility to CAL,and when NT-pro BNP≥272.33 pg/m L,KD children had increased CAL susceptibility.And the higher the NT-pro BNP level,the higher the CAL susceptibility of KD children(272.33 pg/m L≤NT-pro BNP<<347.15 pg/m L,NT-pro BNP≥347.15 pg/m L OR values were 2.629,4.386;95% CI: 2.034~4.695,3.872~5.970).When CRP < 62.73 mg/L,the susceptibility of KD children to CAL was extremely low,and when CRP ≥ 62.73 mg/L,the susceptibility of KD children to CAL increased,and the higher the CRP level,the higher the susceptibility of KD children to CAL(62.73 mg/L).The OR values of L≤CRP<82.06 mg/L and CRP≥82.06 mg/L were 2.087,3.673;95%CI: 1.916~3.877,2.938~4.069).5.There were significant differences in the levels of s B7-H3,NT-pro BNP and CRP among the different CAL recovery time groups(P<0.05).6.s B7-H3 was negatively correlated with the recovery time of CAL in children with KD(r=-0.908,P=0.000).The levels of NT-pro BNP and CRP were positively correlated with the recovery time of CAL in children with KD(r=0.942,0.888,both p=0.000).Conclusions1.The serum levels of NT-pro BNP and CRP in KD children were significantly higher than those in children with fever and healthy children,and the serum s B7-H3 was significantly lower than those in children with fever and healthy children.2.The increase of serum NT-pro BNP and CRP and the decrease of serum s B7-H3 often indicate that the disease of children with KD is aggravated and the susceptibility of cardiovascular disease is increased.The more,the greater the risk of CAL.3.Serum levels of NT-pro BNP,s B7-H3 and CRP are correlated with the recovery time of CAL in children with KD,and be used as biological markers for the diagnosis and prognosis of KD. |
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