The Level Changes And Significance Of Peripheral Blood Neutrophil CD64 In Children With Kawasaki Disease

ObjectiveTo investigate the level changes of peripheral blood neutrophil CD64 in children with Kawasaki disease(KD)and find the significance of CD64.Methods63[42 males and 21 females,age from 2 months to 9 years,average age(2.81±2.35)years]newly diagnosed KD children were divided into 2 groups,38[27 males and 11females,age from 2 months to 9 years,average age(2.91±2.71)years]patients were dignosed as typical KD and 25[15 males and 10 females,age from 3 months to 7 years,average age(2.64±1.70)years]patients were dignosed as atypical KD,and 15[7 males and 8 females,age from 2 months to 7 years,average age(2.69±2.48)years]healthy children served as control group.KD patients were all first dignosed,and were not treated with intravenous immunoglobulin(IVIG),glucocorticoid and immunosuppressor.Patients'blood samples were collected on the next day morning after hospitalization and the healthy children'were collected in outpatient department.CD64 was determined by flow cytometry,serum procalcitonin(PCT)was determined by Roche Cobas e601automatic immunity analyzer,serum C-reactive protein(CRP)was determined by Roche Modular automatic biochemical analyzer,and the White blood cell count(WBC)and the percentage of neutrophils(Neu%)were determined by Sysmex XE2100.Comparing the results of these datas by statistical methods.Statistical analysis was analyzed by SPSS 20.0 software.The normal distribution measurement datas were expressed with the Mean±Standard deviation(?x±s),and compared by two independent samples t test,and the means of multiple groups were comapred by one-way ANOVE.The measurement datas of non normal distribution were expressed in median(quartile)[(M(P25,P75)],compared by rank sum test.The enumeration datas were compared by?~2 test.The P value<0.05 was statistically significant.The receiver operating characteristic curve(ROC curve)was drawed to select the cutoff value and confirme the specificity,sensitivity,positive predictive value and negative predictive value of CD64.And carrying out the correlation analysis between CD64 and PCT,CRP,WBC,Neu%.Results1.Before the treatment,the levels of CD64,WBC,Neu%,CRP,PCT in children with KD were significantly higher than those of control group(P<0.05).2.There were no significant differences between typical KD group and atypical KD group for the levels of CD64,WBC,Neu%,CRP,PCT(P>0.05).3.Correlation analysis showed that CD64 had no relationship with WBC,Neu%and CRP,but it had significant positive relationship with PCT.4.According to the ROC curve,the cutoff value to dignose the KD with bacterial infection of CD64 was 37.5%,the sensitivity was 86%,the specificity was 100%,the positive predictive value was 100%,and the negative predictive value was 87.7%.The cutoff value of PCT was 0.062 ng/ml,the sensitivity was 85%,the specificity was86.7%,the positive predictive value was 86.6%,and the negative predictive value was66.1%.5.The area of CD64 under the ROC curve was 0.936(P=0.000,95%confidence interval(CI):0.865-1.000),and the AUC of PCT was 0.860(P=0.000,95%CI:0.747-0.972).ConclusionThe levels of peripheral blood neutrophil CD64 can be used as a marker for KD with bacterial infection,with a high sensitivity and specificity.