Clinical Significance Of ANCA,NLR And PLR Detection In Kawasaki Disease

Purposes:To investigate the expression of anti-neutrophil cytoplasmic antibody(ANCA),neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in Kawasaki disease and its diagnostic and the predictive value in coronary artery lesion.Methods:A total of 172 children with Kawasaki disease diagnosed in Jiangxi Children's Hospital during October 01,2018 and September 30,2018 were studied and analyzed.50 children with Henoch-Schonlein purpura,45 children with fever caused by upper respiratory tract infection and 40 healthy children were randomly selected as control group.Antineutrophil cytoplasmic antibody(ANCA)was detected by indirect immunofluorescence method,anti-myeloperoxidase antibody and anti-protease 3antibody were quantitatively detected by ELISA,neutrophil absolute value to lymphocyte absolute value ratio(NLR),platelet absolute value to lymphocyte absolute value ratio(PLR)were detected by electrical impedance method.Results:(1)The positive rate of ANCA in serum of children with Kawasaki disease was 63.37%,which was significantly higher than that of the control group(P < 0.01);And the serum concentration of anti-myeloperoxidase antibody in children with Kawasaki disease was11.19+11.07(U/ml)significantly higher than that of acontrol group(P<0.01).(2)The levels of NLR and PLR in children with Kawasaki disease were significantly higher than those in the control group(P < 0.01).(3)Incomplete Kawasaki disease is more likely to occur in younger children.The proportion of male children in coronary lesion group was significantly higher than that in non-coronary lesion group;(4)ANCA,MPO,PR3,NLR and PLR levels are correlated with the occurrence of CAL;(5)ROC curve analysis shows that when MPO is greater than14.7U/ml,the sensitivity,specificity and AUC of predicting CAL are 54.1%,64.8%and 72.5%,respectively;the sensitivity,specificity and AUC of predicting CAL with NLR(>2.17)are 95.1%,42.3% and 68.2%;The sensitivity,specificity and AUC were 72.1%,78.4% and 74.7% respectively.Conclusions:1.ANCA,MPO,NLR and PLR are associated with Kawasaki disease,and they are highly expressed in children with KD.2.2.MPO is the main target antigen of KD.3.The level of PLR in children with incomplete Kawasaki disease was higher than that in children with incomplete Kawasaki disease.4.ANCA,MPO,PR3,NLR and PLR are related to the occurrence of coronary artery disease,and can be used as early predictors of coronary artery disease.5.ROC curve analysis showed that the sensitivity,specificity and AUC of predicting CAL were 54.1%,64.8%,72.5%,95.1%,42.3% and 68.2% when MPO was greater than 14.7U/ml,72.1%,78.4% and 74.7% respectively.