| Objective:By detecting the expression level of micro RNA-145 in the serum of children,and analyzing whether there was a difference in the expression of Kawasaki disease and the control group,this study aims to find new biomarkers that can identify Kawasaki disease early.Further analysis of its expression level in Kawasaki disease coronary artery injury was performed in order to discover biomarkers for early prediction of Kawasaki disease coronary artery injury and provide a basis for early prevention and treatment of coronary artery injury.Method:Frist,children with Kawasaki disease(n=28)admitted to the Children's Hospital of Soochow University from May 2019 to January 2020 were taken as the research subjects,and children admitted to the hospital during the same period for infection group(n=28)and elective surgery(n=27)were also included as controls groups.(1)Collect and compare the clinical data and laboratory examinations of the three groups of children,including fever days,age,white blood cell,neutrophil to lymphocyte ratio,platelets,C-reaction protein,hemoglobin,alanine aminotransferase,and albumin expression levels at admission.(2)The expression levels of interleukin 6,interleukin 8,interleukin 10 and interferon y in the three groups were detected and compared by flow cytometry.(3)The levels of micro RNA-145 in the serum of the three groups were compared and analyzed by real-time quantitative polymerase chain reaction detection.Second,based on the above-mentioned data of children with Kawasaki disease,they were further divided into coronary artery injury and non-coronary artery injury groups.After supplementing the sample size,there were 24 Cases in the coronary artery injury group,and 25 cases in non-coronary artery injury group.?Collect,compare and analyze clinical data of two groups of children in laboratory tests,including fever days,age,white blood cells,platelets,hemoglobin,C-reactive protein,alanine aminotransferase,albumin,immunoglobulin A,immunoglobulin G,immunoglobulin M and other expression levels.?The RT-qPCR detection technology was used to compare and analyze the expression level of micro RNA-145 in the serum of the two groups of children.Results:Comparison of relevant data and test results of Kawasaki disease group,infection group and normal control group:First,comparison of general clinical data:?Gender,age,and weight of children in the Kawasaki disease group and infection group were not significantly different from those in the non-infected control group(P>0.05).?There was no significant difference in the number of days of fever between patients in the Kawasaki disease group and the infection group(P>0.05).Second,comparison of laboratory test results:?The levels of white blood cells,neutrophil to lymphocyte ratio and C-reactive protein in the Kawasaki disease group and infection group were higher than those in the non-infected control group(P<0.05).Hemoglobin levels in the Kawasaki disease group and infection group were lower than those in the non-infected control group(P<0.05).?The level of alanine aminotransferase in the Kawasaki disease group was higher than that in the infection group and the non-infected control group(P<0.05).There was no significant difference in the level of alanine aminotransferase in the infection group and the non-infected control group(P>0.05).?The albumin level of the Kawasaki disease group was lower than that of the infection group and the non-infected control group(P<0.05).There was no significant difference in the albumin level between the infection group and the non-infected control group(P>0.05).?There were no significant differences in platelets among children in the Kawasaki disease group,infection group and non-infected control group(P>0.05).Third,comparison of serum inflammatory factor expression levels:?The levels of serum interferon-y,interleukin-6,and interleukin-8 of children in the Kawasaki disease group and infection group were higher than those in the non-infected control group(P<0.05),but there were no significant differences in serum interferon-y,interleukin-6,interleukin-8,and interleukin-10 expression levels among children in the Kawasaki disease group and infection group(P>0.05).?The serum interleukin-10 expression level of children in the Kawasaki disease group was higher than that in the infection group and non-infected control group(P<0.05),but the levels of serum interleukin-10 were not significantly different in the infection group and the non-infected control group(P>0.05).Fourth,comparison of serum micro RNA-145 expression levels:?The expression levels of micro RNA-145 in serum of Kawasaki disease group and infection group were significantly higher than that in the non-infected control group(P<0.05).?The expression level of microRNA-145 in serum of Kawasaki disease group was higher than that in infection group(P<0.05).Fifth,correlation and regression analysis of serum micro RNA-145 with laboratory inspection and inflammatory factors:There were positive correlations between serum micro RNA-145 and interleukin-6,interleukin-8,interleukin-10,white blood cells,and C-reactive protein(P<0.05).Sixth,logistic regression analysis of serum microRNA-145 and related indicators to predict Kawasaki disease:the univariate analysis between the Kawasaki disease group and the infection group of P<0.1 indicators(micro RNA-145,IL-10,IL-6,ALT,Alb,WBC)into the logistic regression equation,it was found that serum micro RNA-145 and Alb were statistically significant biological indicators for predicting Kawasaki disease.(P<0.05).Seventh,the predictive efficacy of serum micro RNA-145 combined with albumin for Kawasaki disease:This study shows that micro RNA-145 and albumin were effective predictors of KD,and the differences were statistically significant(P<0.05).The working characteristic curves of the receivers were drawn.The areas under the curve of micro RNA-145,and albumin are:0.732,0.783.The AUC comparison of the index and the joint indicators shows that the joint indicators have the highest predictive power for KD and are superior to the individual indicators.Comparison of relevant data and test results of Kawasaki disease CAL group and NCAL group:First,comparison of general clinical data:There were no significant differences among gender,age and fever days with Kawasaki disease coronary artery injury group and non-coronary artery injury group(P>0.05).Second,comparison of laboratory tests:There were no significant differences between children with Kawasaki disease coronary artery injury group and non-coronary artery injury group in white blood cells,neutrophil to lymphocyte ratio,hemoglobin,platelets,C-reactive protein,alanine aminotransferase and albumin,the expression levels of immunoglobulin A,immunoglobulin G,and immunoglobulin M(P>0.05).Third,comparison of serum micro RNA-145 expression levels:The serum micro RNA-145 expression levels in children with Kawasaki coronary artery injury group were significantly higher than those without coronary artery injury group(P<0.05).Fourth,evaluation of serum micro RNA-145 in predicting coronary artery injury caused by Kawasaki disease:?Multivariate logistic regression analysis showed that serum micro RNA-145 is a relevant factor affecting coronary artery injury in Kawasaki disease(OR=1.711,95%CI:1.005?1.087).?The ROC curve of coronary artery injury caused by serum micro RNA-145 and Kawasaki disease was plotted:AUC was 0.731,95%confidence interval was 0.586?0.879,cutoff was 1.680,sensitivity was 75.00%,and specificity was 76.00%.Conclusion:(1)The high level of serum microRNA-145 in children with Kawasaki disease suggests that microRNA-145 may be involved in the pathogenesis of Kawasaki disease.It is considered that it has certain diagnostic value for Kawasaki disease.(2)The detection of serum microRNA-145 combined with albumin has a better predictive effect on Kawasaki disease,is better than a single indicator test,and may become a new combination biomarker for the diagnosis of Kawasaki disease.(3)The expression level of serum microRNA-145 in children with Kawasaki coronary artery injury group was significantly higher than that in patients without coronary artery injury group,suggesting that microRNA-145 participates in the process of coronary artery injury in Kawasaki disease and may be one of the predictors of coronary artery injury in Kawasaki disease. |
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