Objective To explore the expression level of serum interleukin 41(IL-41)and angiotensin-converting enzyme 2(ACE2)and the clinical diagnostic value of pediatric Kawasaki disease(KD).Methods Eighty cases of KD chil-dren diagnosed and treated in the Department of General Pediatrics of Hefei Maternal and Child Health Hospital from De-cember 2018 to December 2022 were selected as the KD group,which were divided into the coronary artery lesion(CAL)subgroup according to echocardiographic results(n=26)and the non-CAL subgroup(n=54),with children with acute up-per respiratory tract infection with fever in the same period as control group 2(n=40)and children with inguinal hernia un-dergoing elective surgery in the same period as control group 1(n=40).The enzyme-linked immunosorbent assay was used to detect the levels of serum IL-41 and ACE2;Pearson's correlation was used to analyze the correlation between serum IL-41 and ACE2 and the clinical data;multifactorial logistic regression was used to analyze the factors affecting the occurrence of CAL in children with KD;and the working characteristic curves of the subjects were plotted to analyze the value of ser-um IL-41 and ACE2 in predicting the occurrence of CAL in children with KD.The working characteristic curves of subjects were plotted to analyze the value of serum IL-41 and ACE2 in predicting CAL in children with KD.Results Comparison of serum IL-41 and ACE2 levels were as follows:KD group＞control 2 group＞control 1 group,and the differences were statistically significant(F/P=519.731/＜0.001,1 115.501/＜0.001);IL-41 and ACE2 levels of KD children were positively cor-related with fever duration,C-reactive protein and calcitoninogen(IL-41:r/P=0.562/＜0.001,0.589/＜0.001,0.613/＜0.001;ACE2:r/P=0.622/＜0.001,0.609/＜0.001,0.574/＜0.001).The CALsubgroup had higher duration of fever,C-reactive protein,calcitoninogen,and IL-41,ACE2 were higher than those in the non-CAL subgroup,and the differences were statistically sig-nificant(t/P=3.459/0.001,11.187/＜0.001,11.377/＜0.001,12.299/＜0.001,25.882/＜0.001).Elevated serum IL-41,ACE2,dura-tion of fever,C-reactive protein,and calcitoninogen were independent risk factors affecting the development of CAL in chil-dren with KD[OR(95%CI)=1.598(1.271-2.010),1.573(1.241-1.994),1.384(1.142-1.667),1.496(1.171-1.912),1.513(1.159-1.975)].The AUCs of serum IL-41,ACE2 and the combination of the two predicted the occurrence of CAL in chil-dren with KD were 0.812,0.815,and 0.878,respectively,and the AUCs of the combination of the two were greater than those of serum IL-41 and ACE2 single test(Z/P=5.116/＜0.001,4.217/0.009).Conclusion Elevated serum IL-41and ACE2in chil-dren with KD are related to the duration of fever,C-reactive protein and calcitoninogen,and the combination of these two tests has a high predictive value for the occurrence of CAL in children with KD.
维普
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