Abstract:

Objective To investigate the changes in serum syndecan-1（SDC-1） and cysteine-containing aspartate-specific protease-1（Caspase-1） levels in children with Kawasaki disease（KD） and their clinical significance. Methods A total of 34 children with KD（KD group），32 children with acute infection（acute infection group） and 32 healthy subjects（healthy control group） were enrolled from Xi'an No.3 Hospital from July 2022 to January 2024. The general data and the results of laboratory routine indicators [white blood cell（WBC） count，hemoglobin（Hb），platelet（PLT） count，C-reactive protein（CRP），albumin（Alb） and so on] were collected，and the serum levels of SDC-1 and Caspase-1 in KD group before treatment and at 2 weeks，1 month，2 months，3 months and 6 months after treatment，as well as in acute infection group and healthy control group were determined. Logistic regression analysis was used to evaluate the influencing factors of KD occurrence. Receiver operating characteristic（ROC） curve was used to analyze the efficacy of each indicator in diagnosing KD. Results The serum levels of SDC-1 and Caspase-1 in healthy control group，acute infection group and KD group were increased successively（P<0.05），and the Hb levels were decreased successively（P<0.05）. The WBC count and CRP level in KD group and acute infection group were higher than those in healthy control group（P<0.05），while there was no statistical significance between KD group and acute infection group（P>0.05）. The serum levels of SDC-1 and Caspase-1 in KD group before treatment were higher than those at 2 weeks，1 month，2 months，3 months and 6 months after treatment（P<0.05）. The serum levels of SDC-1 and Caspase-1 in KD group showed a continuous downward trend from 2 weeks to 3 months after treatment（P<0.05）. There was no statistical significance between the 3-month and 6-month periods after treatment（P>0.05）. The increase of SDC-1 and Caspase-1 was a risk factor for KD（P<0.05）. The areas under curves（AUC） of SDC-1 and Caspase-1 single and combined determinations for differentiating KD and acute infection were 0.693，0.809 and 0.849，respectively. Conclusions The serum levels of SDC-1 and Caspase-1 in KD children are increased，and their levels decrease after treatment，which may be used as auxiliary diagnostic and disease assessment indicators for KD.

Key words: Syndecan-1, Cysteine-containing aspartate-specific protease-1, Kawasaki disease