| Objective:By examining 61 cases of hospitalized children with Kawasaki disease before and after treatment serum concentration of interleukin-6?IL-6?and interleukin-8?IL-8?and interleukin-10?IL-l0?,tumor necrosis factor-??TNF-??,procalcitonin?PCT?and plasma D-dimer?D-D?,and comparing the research objects with Logistic regression analysis to discuss its correlation with coronary artery injury?CAL?in Kawasaki disease.Methods:From Sep.2016 to Jul.2017,61 hospitalized children with Kawasaki disease in the pediatric department of Affiliated Anqing Hospital of Anhui Medical University were enrolled in the research groups?all the patient coincided with the diagnosis standard mentioned in[Zhu Futang Practice of Pediatrics,8th edition]?.According to the results of echocardiography,they were divided into coronary artery injury?CAL?group?10 cases?and non-coronary artery injury group?51 cases?;children with pneumonia who had a fever for 3-5days in the same period were selected as the control group?50 cases?.Each group was researched before and after treatment.The concentration levels of serum cytokine spectrum,PCT and plasma D-D before and after treatment were detected respectively with enzyme-linked immunosorbent assay?ELISA?,electrochemiluminescenceandimmunoturbidimetry.Measurement datas,normally distributed and represented as??x±s?,were analyzed with t-test.Skew distributed datas expressed as M?QR?,were analyzed with Rank Sum Test.Multiple logistic regression analyses were used to screen risk factors of kawasaki disease along with coronary artery injury.All datas were recorded and analyzed by SPSS16.0software,the result of P<0.05 for the difference was statistically significant.Results:1.Age of each group is Skew distributed through test of normality,and analyzed with Rank Sum Test,the results are expressed as M?QR?.Gender is tested with?2-test,the results showed that comparative differences of age and gender among three groups are not statistically significant?p>0.05?,so age and gender among groups are comparable.2.The concentration levels of serum IL-6,IL-8,IL-10,TNF-?,PCT and plasma D-D of three groups is normally distributed through test of normality,differences of two samples are compared with t-test.More samples are compared with variance analysis.Three groups are compared with LSD-t test.The concentration levels of serum IL-6,IL-8,IL-10,TNF-?,PCT and plasma D-D in CAL pre-treatment group are obviously higher than those in non-CAL group and pneumonia control group,the differences are statistically significant?P<0.05?.The concentration levels of examination index in non-CAL pre-treatment group were higher than those in control group;the concentration levels of examination index in CAL pre-treatment group are obviously higher than those in CAL post-treatment,and the difference is statistically significant.The levels of IL-6?IL-8?TNF-??PCT?D-D in non-CAL pre-treatment group were remarkably higher than those in non-CAL post-treatment group,and the difference is statistically significant.The concentration levels of IL-10 in the non-CAL pretreatment group were?25.43+14.29?ng.L-1,higher than the non-CAL post-treatment group?21.13+12.93?ng.L-1,but the difference was not statistically significant?t=1.59,P=0.115>0.05?.3.Choose kawasaki disease along with CAL to be dependent variable.Compare the concentration levels of IL-6/IL-8/IL-10/TNF-?/PCT/D-D and age/gender with multi-factors two classification Logistic regression analysis,finally we choose the concentration levels of IL-10?TNF-??D-D.The Wald?2 value of IL-10?TNF-??D-D are respectively 6.444?6.464?5.744;OR are respectively 1.095?1.249?3.699;P value are respectively 0.011?0.011?0.017.So IL-10,TNF-?,D-D were risk factors for Kawasaki disease along with coronary artery lesions.Conclusion:1.The concentration levels of serum IL-6,IL-8,IL-10,TNF-?,PCT and plasma D-D in CAL pre-treatment group are obviously higher than those in non-CAL group and pneumonia control group.the concentration levels of examination index in CAL pre-treatment group are obviously higher than those in CAL post-treatment.The concentration levels of examination index in non-CAL pre-treatment group were higher than those in control group;The levels of IL-6?IL-8?TNF-??PCT?D-D in non-CAL pre-treatment group were remarkably higher than those in non-CAL post-treatment group,and the difference is statistically significant,these showed that they played very important role in flare-ups of Kawasaki Disease2.IL-10 in CAL group are higher it in non-CAL group and control group,IL-10 is a protective factor in acute phase of KD,which can suppress the inflammation and CAL.The concentration levels of IL-10 in the non-CAL pretreatment group were higher than the non-CAL post-treatment group,but the difference isn't statistically significant,and this maybe caused by its high concentration,because it may lead immune response out of control,the serum concentration after treatment remained a high level for a long time.3.The plasma D-D in non-CAL pre-treatment group is higher than it in control group and non-CAL post-treatment group;The concentration levels of D-D in CAL pre-treatment group was higher than the D-D concentration of control group/non-CAL group and CAL post-treatment group,it indicated that children with KD were in hypercoagulable state,and an unbalance exist in coagulation system and fibrinolytic system.Detecting the elevated D-D concentration level worth a lot to predicting CAL of KD.4.Itscoronary artery lesions.Multi-factors two classification Logistic regression analysis showed that concentration levels of IL-10?TNF-??D-D are risk factors of Kawasaki Disease along with coronary artery lesions,so they can be early test of KD with CAL. |
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