Abstract
BACKGROUND: To compare the expression levels of serum ferritin and plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) in children over 1 year with Kawasaki disease (KD) and explore the early predictive value of the combined detection of these two indicators for the occurrence of intravenous immunoglobulin (IVIG) resistance and coronary artery lesions (CALs) in KD patients. METHODS: A total of 320 children over 1 year of age with KD were retrospectively studied. All participants had peripheral blood samples collected at specific times to test laboratory indicators such as serum ferritin and NT-proBNP. The patients were divided into an IVIG-resistant group and an IVIG-responsive group on the basis of the initial IVIG treatment effect. According to the results of cardiac ultrasound, the patients were divided into a CAL group and a non-CAL group. SPSS 25.0 software was used for data analysis. Receiver operating characteristic (ROC) curves were used to evaluate the early diagnostic efficacy of various indicators for IVIG resistance and CALs in KD patients. RESULTS: Logistic regression analysis revealed that the neutrophil percentage and duration of fever before initial IVIG were independent influencing factors of IVIG resistance in KD patients. IVIG resistance, duration of fever before initial IVIG, and serum albumin level were found to be independent influencing factors of CALs. ROC curve analysis revealed that the area under the curve (AUC) of NT-proBNP for identifying IVIG resistance in KD patients was 0.698. When the cutoff value of NT-proBNP was 419.6 pg/mL, the diagnostic efficacy for IVIG resistance in KD patients was the highest, with a sensitivity of 81.3% and a specificity of 53.0%. The ROC curve analysis revealed that the AUC of NT-proBNP combined with serum ferritin for identifying CALs in KD patients was 0.666, and the diagnostic efficiency of CALs was the highest. CONCLUSIONS: In children over 1 year of age with KD, the level of NT-proBNP could be used as an early predictor of IVIG resistance and CALs, and the serum ferritin level could be used as an early predictor of CALs. The diagnostic efficacy of CALs can be further improved when NT-proBNP and serum ferritin are jointly detected.