Research On The Serum Level And Clinical Significants Of CK-MB,NT-proBNP,H-FABP In Infants With Kawasaki Disease

OBJECTIVE KD is a non-specific systemic small vasculitis,involving the coronary arteries can cause Ischemic Heart Disease and Acute Myocardial Infarction(AMI),seriously endanger children life.In the early stage of KD,clinical symptoms and signs become unconspicuous,the clinical application of biomarkers in early assessment is critical.Parts of markers’ serum level affected by age.This study intends to explore the value of the combined detection of CK-MB,NT-pro BNP and H-FABP in predicting the risk of CAL in infants with KD through diagnostic test and obtain the cut-off value.METHODS Fifty-five cases of infant with KD admitted to our hospital from September 2018 to December 2020 were selected as the case group,and 55 cases of infant undergoing health examination in the outpatient department during the same period were selected as the control group.The case group was again divided into infant KD with CAL group and infant KD without CAL group according to the results of echocardiography.Blood samples were collected for CK-MB,NT-pro BNP and H-FABP levels in case group and control group.First,statistical differences in age and gender were compared between the case group and the control group.Spearman correlation was used to analyze the correlation between the levels of CK-MB,NT-pro BNP and H-FABP in the case group and age.Non-parametric Mann-Whitney U rank sum test was used to compare the levels of CK-MB,NT-pro BNP and H-FABP in the infant KD with CAL group and the infant KD without CAL group.Respectively for cases and infant KD with CAL group CK-MB,NT-pro BNP,H-FABP three indicators of logistics single factor and multiple factors regression analysis,finally draw CK-MB,NT-pro BNP and H-FABP predict CAL ROC curve,through the Area Under the Curve to evaluate and compare the three diagnostic performance,Maximum Approximate Index was used to gain the cutoff value of CK-MB,NT-pro BNP,H-FABP for predicting CAL.RESULTS There was no significant difference in age and gender between the two groups(P>0.05).The serum levels of CK-MB,NT-pro BNP and H-FABP in case group were significantly higher than those in control group,and the difference was statistically significant(P< 0.05).The level of CK-MB,NT-pro BNP and H-FABP in the CAL group was significantly higher than that in the control group.The area under the ROC curve of CK-MB predicting the risk of CAL was 0.865,NT-pro BNP was 0.732 and H-FABP was 0.878.The cut-off value of CK-MB was 39.4U/L(sensitivity 88.2%,specificity 78.9%),and the cut-off value of NT-pro BNP was 2381.5ng/ d L(sensitivity 70.6%,specificity 68.4%).H-FABP cutoff value of13.095ng/ml(sensitivity 82.4%,specificity 84.2%)could predict the risk of CAL in infant KD.CONCLUSION 1.There were certain concentrations of CK-MB,NT-pro BNP and H-FABP in serum of KD infants and normal healthy infants,but the serum concentration of KD infants was higher than that of healthy control group,and the difference was statistically significant(P < 0.05).2.CK-MB,NT-pro BNP and H-FABP can all be used to predict the risk assessment of CAL in children with KD,and H-FABP has higher diagnostic performance than CK-MB and NT-pro BNP.3.When the level of serum CK-MB exceeds 39.4U/L,the level of NT-pro BNP exceeds 2381.5ng/d L,and the level of H-FABP exceeds 13.095ng/m L in infants and young children,the occurrence of CAL should be vigilant.