To Explore The Prediction Index Of IVIG-resistant KD And The Relationship Between CaSR And Kawasaki Disease

Objectives: To analyze the clinical data of 102 children with Kawasaki disease,and to explore the effective index predicting the IVIG resistant Kawasaki disease.Then to determine the diagnostic limit through the statistical analysis.Furthermore,to confirme the expression of Ca SR in blood lymphocytes of children with Kawasaki disease,which was higher than that in control group.To further clarify the pathogenesis of Kawasaki disease and provide new ideas for the treatment of Kawasaki disease.Materials and Method:1.The date of 102 patients with KD who were newly diagnosed in Tianjin General Hospital from January 2012 to January 2016 were selected.There were 64 males and 38 females and their age ranged from 3 months to 8 years.Subjects were then divided into two groups:IVIG-responsive and IVIG-resistant to analysis the general data,clinical features,laboratory examination,auxiliary examination and to explore the effective index predicting the IVIG resistant Kawasaki disease.2.The data of 40 children with KD in our hospital from January 2015 to January 2017 were selected as the experimental group.There were 25 boys and 15 girls,with an average age of 1.95± 1.69 years old.Another 25 healthy children were selected as the control group,including 15 boys of and 10 girls,with an average age of 1.85±1.71 years old.Before IVIG treatment,the expression of Ca SR in blood lymphocytes were detected in two groups of subjects with Western blot(Western Blot)technology;After IVIG treatment,the expression of Ca SR was detected again in KD group.Results:1.For the two groups of KD patients,the levels of plasma BNP and CRP in IVIG-resistant group were higher than the IVIG-responsive group and were independent risk factors for resistance to IVIG.When the level of plasma BNP was higher than 746.3 ng/L,the predictive sensitivity in patients with KD was 0.917,the specificity was 0.674;the level of CRP was higher than 100mg/L,the predictive sensitivity in patients with KD was 0.667,the specificity was 0.80.2.In this study,we confirmed that the expression of Ca SR in lymphocytes of children with Kawasaki disease before IVIG treatment was high,but the expression of CaSR in the control group was not very high,and the expression of CaSR was significantly decreased after treatment with IVIG.Conclusions:1.The level of plasma BNP or CRP regarded as a predictor of IVIG resistant Kawasaki disease is limit.2.The expression of Ca SR in lymphocytes of children with Kawasaki disease may have relationship with MAPK and NF-kβ signal pathway.In the future,Ca SR may become new specific indicator of prediction,diagnosis and treatment to Kawasaki disease.And to further clarify the pathogenesis of Kawasaki disease and provide new ideas for the treatment of Kawasaki disease.