期刊
KOREAN CIRCULATION JOURNAL
卷 48, 期 1, 页码 71-79出版社
KOREAN SOC CARDIOLOGY
DOI: 10.4070/kcj.2017.0136
关键词
Mucocutaneous lymph node syndrome; Intravenous immunoglobulins; Coronary artery disease; Natriuretic peptide; Brain; Neutrophils
Background and Objectives: Approximately 10-15% of children with Kawasaki disease (KD)do not respond to initial intravenous immunoglobulin (IVIG) and have higher risk for coronary artery lesion (CAL). The aim of this study was to identify predictive factors from laboratory findings in patients who do not respond to IVIG treatment and develop CAL from KD.& para;& para;Methods: We retrospectively collected nationwide multicenter data from the Korean Society of Kawasaki Disease and included 5,151 patients with KD between 2012 and 2014 from 38 hospitals.& para;& para;Results: Among 5,151 patients with KD, 524 patients belonged to the IVIG-resistant group. The patients in the IVIG-resistant group had a significantly higher serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level (1,573.91 +/- 3,166.46 vs. 940.62 +/- 2,326.10 pg/mL; p<0.001) and a higher percentage of polymorphonuclear neutrophils (PMNs) (70.89 +/- 15.75% vs. 62.38 +/- 32.94%; p<0.001). Multivariate logistic regression analyses revealed that significantly increased PMN, NT-proBNP, C-reactive protein (CRP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were the predictors of IVIG resistance (p<0.05). Multivariate logistic regression analyses also showed that only CRP was associated with the risk of CAL (p<0.01), while PMN, NT-proBNP, AST, and ALT were not.& para;& para;Conclusions: Elevated PMN, serum NT-proBNP, CRP, AST, and ALT levels are significantly associated with IVIG resistance in patients with KD. Moreover, serum CRP is significantly increased in patients with KD with CAL.
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