Roles of lymphocyte subsets，inflammatory factors and NT-proBNP in diagnosis of Kawasaki disease

doi:10.3969/j.issn.1673-8640.2023.06.005

Abstract

Abstract:

Objective To investigate the changes and roles of lymphocyte subsets，inflammatory factors and myocardial marker in children with acute Kawasaki disease（KD）. Methods From October 2016 to March 2019，222 acute KD children and 177 non-KD children with infection and fever were enrolled from Children's Hospital of Shanghai. Lymphocytes were determined by flow cytometry. The levels of 13 inflammatory factors [interleukin（IL）-8，IL-1β，IL-2，IL-6，IL-10，IL-4，IL-5，IL-12P70，IL-17A，IL-18，tumor necrosis factor-alpha（TNF-α），interferon-gamma （INF-γ）and sCD25] were determined flow cytometry and immunofluorescence technique Peripheral blood lymphocytes were determined by flow cytometry. The expressions of inflammatory cytokines and lymphocytes in peripheral blood of children with KD in acute phase and non-KD patients with fever-infected were compared. The expressions of inflammatory factors were compared before and after intravenous injection gamma globulin （IVIG） in children with KD. The changes of cardiac markers，including cardiac troponin I （cTnI），myoglobin （MYO） and N-terminal pro-B-type natriuretic peptide （NT-proBNP），in 145 children with KD in acute phase were determined，and the correlations were analyzed. Results Compared with children with infection and fever，other inflammatory factors except IL-2 were increased in children with KD（P<0.05）. Peripheral blood CD3⁺CD4⁺ T cell percentage，CD16⁺CD56⁺ natural killer cell percentage，CD4/CD8 were increased，and CD3⁺CD8⁺ T cell percentage was decreased （P<0.05）. The absolute value of CD16⁺CD56⁺ natural killer cells was increased，and the absolute value of CD3⁺CD8⁺ T cells was decreased （P<0.05）. After treatment，serum IL-8，IL-1β，IL-2，IL-6，IL-10，IL-18，TNF-α and sCD25 were decreased（P<0.05）. There was no significant increase of cTnI and MYO in peripheral blood of children with KD. There was a significant increase of NT-proBNP in peripheral blood of 62% children，which was positively correlated with IL-6，IL-10，IL-17A，IL-18，TNF-α，INF-γ，sCD25，the percentage and absolute value of CD19⁺ B cells，CD4/CD8，and which was negatively correlated with the percentage of CD3⁺CD8⁺ T cells. Conclusions There is up-regulation of inflammatory factors and imbalance of lymphocyte subsets in acute KD. The determination of NT-proBNP combined with immune cells and inflammatory factors can assist clinical diagnosis and treatment.

Key words: Lymphocyte subset, Inflammatory factor, N-terminal pro-B-type natriuretic peptide, Kawasaki disease

CLC Number:

R446.1

LIU Yanan, XIA Min, HU Shaohua, ZHENG Yue, ZHANG Hong. Roles of lymphocyte subsets，inflammatory factors and NT-proBNP in diagnosis of Kawasaki disease[J]. Laboratory Medicine, 2023, 38(6): 532-537.

Figures/Tables 6

References 17

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组别	例数	IL-8									IL-1β				IL-2
组别	例数	P₅₀		P₇₅	P₉₀				P₉₅		P₅₀	P₇₅	P₉₀	P₉₅	P₅₀	P₇₅	P₉₀	P₉₅
KD组	222	0.10		20.40	323.56				574.34		0.10	0.10	2.74	6.88	0.10	0.10	0.10	2.75
感染发热组	177	0.10		0.10	18.08				101.09		0.10	0.10	0.10	0.10	0.10	0.10	0.10	0.10
Z值		-5.347									-3.812				-1.893
P值		<0.001									<0.001				0.058
组别	IL-6				IL-10						IL-4				IL-5
组别	P₅₀	P₇₅	P₉₀	P₉₅	P₅₀			P₇₅	P₉₀	P₉₅	P₅₀	P₇₅	P₉₀	P₉₅	P₅₀	P₇₅	P₉₀	P₉₅
KD组	0.10	25.11	14.91	357.13	0.10			7.64	29.48	60.92	0.10	0.10	0.10	5.89	0.10	0.10	0.10	5.89
感染发热组	0.10	0.10	0.10	0.29	0.10			0.10	3.02	15.41	0.10	0.10	0.10	0.10	0.10	0.10	0.10	0.10
Z值	-7.314				-6.687						-3.008				-3.239
P值	<0.001				<0.001						<0.001				0.001
组别	IL-12P70										IL-17A				IL-18
组别	P₅₀		P₇₅			P₉₀			P₉₅		P₅₀	P₇₅	P₉₀	P₉₅	P₅₀	P₇₅	P₉₀	P₉₅
感染发热组	0.10		0.10			0.10			22.85		0.10	0.10	0.10	0.60	0.10	7.95	136.64	191.66
KD组	0.10		0.10			0.10			27.85		0.10	0.10	0.91	1.70	18.90	75.51	148.66	252.16
Z值	-2.856										-4.178				-5.950
P值	0.004										<0.001				<0.001
组别	TNF-α										INF-γ				sCD25
组别	P₅₀		P₇₅				P₉₀		P₉₅		P₅₀	P₇₅	P₉₀	P₉₅	P₅₀	P₇₅	P₉₀	P₉₅
KD组	0.10		0.10				3.01		5.75		0.23	2.77	20.06	112.48	27 214.81	47 688.36	92 148.49	126 074.00
感染发热组	0.10		0.10				0.10		0.10		0.10	1.00	26.21	47.45	15 896.00	23 829.98	32 245.89	36 403.40
Z值	-5.420										-3.628				-7.521
P值	<0.001										<0.001				<0.001

组别	例数	IL-8									IL-1β				IL-2
组别	例数	P₅₀		P₇₅	P₉₀				P₉₅		P₅₀	P₇₅	P₉₀	P₉₅	P₅₀	P₇₅	P₉₀	P₉₅
KD组	222	0.10		20.40	323.56				574.34		0.10	0.10	2.74	6.88	0.10	0.10	0.10	2.75
感染发热组	177	0.10		0.10	18.08				101.09		0.10	0.10	0.10	0.10	0.10	0.10	0.10	0.10
Z值		-5.347									-3.812				-1.893
P值		<0.001									<0.001				0.058
组别	IL-6				IL-10						IL-4				IL-5
组别	P₅₀	P₇₅	P₉₀	P₉₅	P₅₀			P₇₅	P₉₀	P₉₅	P₅₀	P₇₅	P₉₀	P₉₅	P₅₀	P₇₅	P₉₀	P₉₅
KD组	0.10	25.11	14.91	357.13	0.10			7.64	29.48	60.92	0.10	0.10	0.10	5.89	0.10	0.10	0.10	5.89
感染发热组	0.10	0.10	0.10	0.29	0.10			0.10	3.02	15.41	0.10	0.10	0.10	0.10	0.10	0.10	0.10	0.10
Z值	-7.314				-6.687						-3.008				-3.239
P值	<0.001				<0.001						<0.001				0.001
组别	IL-12P70										IL-17A				IL-18
组别	P₅₀		P₇₅			P₉₀			P₉₅		P₅₀	P₇₅	P₉₀	P₉₅	P₅₀	P₇₅	P₉₀	P₉₅
感染发热组	0.10		0.10			0.10			22.85		0.10	0.10	0.10	0.60	0.10	7.95	136.64	191.66
KD组	0.10		0.10			0.10			27.85		0.10	0.10	0.91	1.70	18.90	75.51	148.66	252.16
Z值	-2.856										-4.178				-5.950
P值	0.004										<0.001				<0.001
组别	TNF-α										INF-γ				sCD25
组别	P₅₀		P₇₅				P₉₀		P₉₅		P₅₀	P₇₅	P₉₀	P₉₅	P₅₀	P₇₅	P₉₀	P₉₅
KD组	0.10		0.10				3.01		5.75		0.23	2.77	20.06	112.48	27 214.81	47 688.36	92 148.49	126 074.00
感染发热组	0.10		0.10				0.10		0.10		0.10	1.00	26.21	47.45	15 896.00	23 829.98	32 245.89	36 403.40
Z值	-5.420										-3.628				-7.521
P值	<0.001										<0.001				<0.001

统计值		IL-8	IL-1β	IL-2	IL-6	IL-10	IL-4	IL-5	IL-12P70	IL-17A	IL-18	TNF-α	INF-γ	sCD25
r值		-0.028	0.100	-0.153	0.416	0.407	-0.047	0.100	0.116	0.259	0.256	0.308	0.238	0.531
P值		0.738	0.231	0.066	<0.001	<0.001	0.574	0.230	0.164	0.002	0.002	<0.001	0.004	<0.001

统计值		IL-8	IL-1β	IL-2	IL-6	IL-10	IL-4	IL-5	IL-12P70	IL-17A	IL-18	TNF-α	INF-γ	sCD25
r值		-0.028	0.100	-0.153	0.416	0.407	-0.047	0.100	0.116	0.259	0.256	0.308	0.238	0.531
P值		0.738	0.231	0.066	<0.001	<0.001	0.574	0.230	0.164	0.002	0.002	<0.001	0.004	<0.001

统计值	CD3⁺ T细胞		CD3⁺CD8⁺ T细胞		CD16⁺CD56⁺自然杀伤细胞		CD19⁺ B细胞		CD4/CD8比值
统计值	百分比	绝对值	百分比	绝对值	百分比	绝对值	百分比	绝对值	CD4/CD8比值
r值	-0.116	0.075	-0.241	-0.032	-0.147	-0.088	0.218	0.190	0.197
P值	0.165	0.368	0.003	0.702	0.077	0.291	0.008	0.022	0.017