Correlation Between Lymphocyte Subsets And Immunoglobulin Levels And Kawasaki Disease

In October 2020,the Japanese Academy of Pediatrics published the 6th revision of the diagnostic guidelines for Kawasaki disease.At present,Kawasaki disease is still defined as a systemic vasculitis disease,which can affect multiple systems throughout the body,especially coronary artery disease,which can even cause myocardial infarction and heart failure in children.It can still affect the quality of life of children in adulthood.In recent years,although the research on Kawasaki disease is more and more extensive and in-depth,however the pathogenesis and diagnosis of Kawasaki disease are still not completely clear,and the diagnosis of incomplete Kawasaki disease,in particular,still faces many challenges.In this study,the changes in the levels of immunoglobulin and lymphocyte subsets to explore whether it can be used for the early diagnosis of Kawasaki disease.Objective:By analyzing the changes in peripheral blood T lymphocyte subsets and immunoglobulin levels of children in the observation group and the control group,we analyzed their correlation with Kawasaki disease and further evaluated their relationship with the occurrence and development of Kawasaki disease,and determined whether these could provide a theoretical basis for the early diagnosis of Kawasaki disease.Methods:A total of 35 children with Kawasaki disease hospitalized in the Department of Pediatric Medicine of the Affiliated Hospital of Chengde Medical College from October 2018 to March 2021 were selected as the KD group,and 49 children with infectious fever(mainly respiratory diseases,such as acute tonsillitis,acute bronchitis,and acute bronchopneumonia)hospitalized in the same period were selected as the control group。The peripheral blood lymphocyte subsets(CD3~+,CD4~+,CD8~+,CD4~+/CD8~+,CD19~+),NK cells,CIK cells,and C-reactive protein(CRP)of the children in the two groups were examined by flow cytometry,and the peripheral blood IgG,IgA,IgM,C3,and C4 of the children were measured by immunoturbidimetry,and all these data of the two groups were analyzed.The difference was considered statistically significant at P<0.05.Results:1.The levels of peripheral blood IgA,IgG and C4 in fever group were higher than those in KD group;The levels of IgM and C3 in KD group were higher than those in febrile group.The percentage of CD3~+,CD8~+and CIK cells in KD group.The absolute value of CD3~+and CD8~+was relatively low,while the percentage of CD19~+,NK cells and the ratio of CD4~+/CD8~+were relatively high.The differences were statistically significant(P<0.05).2.The area under the receiver operating characteristic(ROC)curve of CRP,WBC,IgG,IgA,IgM,C3,C4,CD19~+,NK cells,CIK cells and CD4~+/CD8~+in children with KD were 0.988,0.850,0.707,0.655,0.642,0.715,0.696,0.629,0.643,0.673,0.663,respectively.Conclusion:1.The levels of CRP,WBC and PLT in the two groups were detected and analyzed,and the ROC curve analysis showed that CRP and WBC had significant value in the diagnosis of KD.2.By detecting and analyzing the levels of lymphocyte subsets in the two groups,combined with ROC curve analysis,it was shown that CD19~+,NK cells,the percentage of CIK cells and the ratio of CD4~+/CD8~+were of significance for the diagnosis of KD.3.Through the detection and analysis of immunoglobulin levels in the two groups of children,combined with the ROC curve analysis,it is shown that IgM,IgA,IgG,C3 and C4 are of significance for the diagnosis of KD.