Predictive value of serum TN-C,LRG1 and sLR11 for non-response to intravenous immunoglobulin therapy in children with Kawasaki disease
Objective To investigate the predictive value of serum tenascin-C(TN-C),leucine-rich α-2 glycoprotein 1(LRG1)and soluble low-density lipoprotein receptor relative with 11 ligand-binding repeats(sLR11)in non-response of children with Kawasaki disease to intravenous immunoglobulin(IVIG).Methods A total of 286 children with Kawasaki disease treated in Shijiazhuang People's Hospital from March 2020 to February 2023 were retrospectively selected as the study objects,all of whom were treated with IVIG.According to the response of patients to IVIG treatment,they were divided into sensitive group and non-response group.The clinical data in two groups were compared,and the influencing factors for their non-response to IVIG treatment were analyzed by multivariate logistic regression.ROC curve was used to evaluate the efficacy of serum TN-C,LRG1,and sLR11 alone and in combination on predicting non-response of patients to IVIG therapy.Results Among the 286 children treated with IVIG,37 did not respond to IVIG treatment,with an incidence of 12.94％.The levels of WBC,neutrophil percentage,CRP,procalcitonin,AST,ALT,serum creatinine,and serum TN-C,LRG1 and sLR11 in the no-response group were higher than those of the sensitive group,while the serum sodium level was lower,the differences of which were all statistically significant(all P＜0.05).Multivariate logistic regression analysis showed that increased serum CRP,TN-C,LRG1 and sLR11 levels were independent risk factors for IVIG non-response in children with Kawasaki disease(all P＜0.05),while the increase of serum sodium was a protective factor(P＜0.05).ROC curve analysis showed that the AUCs of serum TNC,LRG1 and sLR11 alone and combined detection in predicting non-response of patients to IVIG treatment were 0.755,0.658,0.789 and 0.898,respectively,and the combined detection of the three factors showed superior predictive performance to the single detection.Conclusion The elevated levels of serum TN-C,LRG1 and sLR11 are all risk factors for non-response to IVIG treatment in children with Kawasaki disease.The combined detection of these three factors has high clinical value for predicting their IVIG treatment non-response.
万方数据
维普
