Significance Of Plasma Prealbumin In Predicting Coronary Artery Disease In Children With Kawasaki Disease

Objective To investigate the significance of plasma prealbumin(PA)level in predicting coronary artery lesion(CAL)in Kawasaki disease(KD).Methods The clinical data of 128 children with KD [82 males and 46 females,age from 2 months to 12 years,average age(2.6±2.34),14 cases were less than 6 months old,17 cases were more than 5 years old] was restrospectively analyzed from January 2014 to December 2018 in our hospital.According to clinical manifestations,98 patients were divided into typical KD group [64 males and 34 females,age from 2 months to 12 years,average age(2.6±2.67),7 cases were less than 6 months old,9 cases were more than 5years old],and 30 patients were divided into atypical KD group [17 males and 13 females,age from 2 months to 9 years,average age(2.7±2.64),7 cases were less than6 months old,7 cases were more than 5 years old].The course of fever before using Intravenous immunoglobulin(IVIG)was 5-14 days,average day(6.30±1.79).According to whether or not combined with coronary artery damage,23 patients were divided into CAL group [16 males and 7 females,age from 3 months to 9 years,average age(3.1±2.70),1 case was less than 6 months old,4 cases were more than 5 years old],105 patients were divided into n CAL group [66 males and 39 females,age from 2months to 12 years,average age(2.5±2.24),13 cases were less than 6 months old,12 cases were more than 5 years old].And 50 children [31 males and 19 females,age from3 months to 7 years,average age(3.8±2.07)] undergoing physical examination at the same time were selected as the control group.All patients' blood samples were collected before the treatment of IVIG.White blood cell count(WBC)?neutrophilic granulocyte count(NEUT)and platelet counts(PLT)were determined by SYSMEX XE-2100(F5192).C-reactive protein(CRP),Albumin(Alb),Alanine aminotransferase(ALT)and prealbumin were determined by Roche modular DPP automatic biochemical analyzer detection.Erythrocyte sedimentation rate(ESR)was determined by ALIFAX MICRO TEST1.The diameter of main coronary artery was determined by color Doppler echocardiography.Comparing the results of these datas by statistical methods.SPSS19.0 was selected for statistical processin.The normal distribution measurement datas were expressed with the Mean ± Standard deviation(`x±s),and compared by two independent samples t test,and the multiple groups were compared by one-way ANOVE.The measurement datas of non-distribution were expressed in median(quartile)[(M(P25,P75)],compared by rank sum test.The enumeration datas were compared by c 2 test.Analysis of relationship of two independent samples were compared by Pearson analysis.The P value <0.05 was statistically significant.Receiver operating characteristics curve(ROC curve)for plasma PA level was built to evaluate the predictive value of PA levels on CAL in children with Kawasaki disease,and then the optimal cut-off point of PA levels was obtained.Diagnostic parameters such as sensitivity and specificity were also calculated for comparison.Analysis of relationship of PA with NEUT,PLT,Alb,ALT,CRP and ESR were compared.Results1.Before the treatment,the level of PA,WBC,NEUT,PLT,Alb,ESR,CRP in children with KD were significantly higher than control group(P<0.05).2.The level of PA,Alb,PLT,CRP in typical KD group were lower than atypical KD group.The level of WBC,NEUT,ALT ESR in typical KD group were higher than atypical KD group.But there were no significant differences between two groups for the level of WBC,NEUT,PA,Alb,CRP(P > 0.05).There were significant differences between two groups for the level of ALT,ESR(P<0.05).3.The level of WBC,NEUT,PLT,ALT,CRP,ESR in CAL group were higher than n CAL group,while the level of PA,Alb were lower than n CAL group.There were no significant differences between two groups for the level of PLT,ALT(P >0.05).There were significant differences between two groups for the level of WBC,NEUT,PA,Alb,CRP,ESR(P<0.05).4.The area of PA under the ROC curve was 0.645(P < 0.05,95% confidence interval(CI): 0.527-0.763).ROC curve showed that when the threshold value of PA level was 82.5mg/L,the sensitivity was 87.0%,and the specificity was 69.5%.Conclusion Plasma PA level is expected to be one of the predictors in KD with CAL.