The Significance Of Elevated Soluble Growth Stimulation Expressed Gene 2 In Children With Kawasaki Disease At Acute Phase

Objectives:To investigate the level and clinical significance of soluble growth stimulation expressed gene 2 protein(sST2)in children with Kawasaki disease(KD)complicated with myocardial damage,coronary artery damage,multiple organ involvement,and IVIG resistance KD.Methods:A retrospective analysis was performed on 287 cases of KD/IKD in pediatric cardiology Department of Shengjing Hospital Affiliated to China Medical University from November 2021 to December 2022.They were grouped according to whether there was myocardial damage,coronary artery damage,≥3organs involved,and whether there was IVIG-R KD:Myocardial damage=group A(17 cases)vs no=Group B(270 cases);With coronary artery lesion(CAL)=group C(48 cases)vs without=group D(239 cases);≥3organs damage=group E(58 cases)vs<3 organs=group F(229 cases);IVIG-R KD=G group(24 cases)vs IVIG sensitive type=H group(263 cases).In respective groups,The level of sST2 is correlated with WBC,HB,PLT,CRP,IL-6,ESR,NT-pro BNP,D-dimer,and ALB.Results:(1)Compared to group D,group C with CAL was younger and more male,showed significant difference(P<0.05).There were no differences in age and gender among other groups(P>0.05).The level of sST2 was elevated in group A,group C,group E,and group G than that in respective groups(P<0.05).(3)Comparison of other tests:CRP,IL-6,NT-pro BNP and D-dimer in group A,group C,group E,and group G were higher than those in respective groups(P<0.05).while ALB and HB in group C,group E,and group G were lower than those in respective groups(P<0.05).(4)Spearman correlation analysis to 0.3≤|r_s|<0.5 as weak correlation,there were weak and positive correlations with WBC,CRP,IL-6,NT-pro BNP and D-dimer,weak and negative correlations with HB and ALB(P<0.05).sST2 has no correlation with ESR and PLT.(5)Multivariate binary Logistic regression analysis showed that male was an independent risk factor for coronary artery damages,sST2,HB and IL-6 were independent risk factors for multiple organ involvement(P<0.05),and sST2 and HB were independent risk factors for IVIG-R KD(P<0.05).ROC analysis showed that sST2 had certain diagnostic value for multi-organ involvement and IVIG-R KD.The areas under the curve are 0.735 and 0.760respectively,and the optimal critical values are 51.264 and 43.4115,respectively.Conclusions:The level of sST2 was elevated at acute phase of KD may indicate severe inflammatory response,myocardial damage,CAL,multiple organ involvement,and IVIG-R KD/IKD.It is correlated with multiple organ involvement and IVIG-R KD,and has certain predictive value for the early diagnosis of multiple organ involvement and IVIG-R KD.