外周血淋巴细胞亚群对静脉注射免疫球蛋白无反应型川崎病患儿的预测价值

doi:10.7499/j.issn.1008-8830.2305067

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Abstract Objective Based on peripheral blood lymphocyte subsets and common laboratory test indexes, this study aimed to construct a predictive scoring system for intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD). Methods Children hospitalized in Tianjin Children's Hospital from January 2021 to March 2023 were included in the study (185 cases of IVIG-sensitive KD and 41 cases of IVIG -resistant KD). Forty-six healthy children matched for age and gender were selected as controls. The relative percentage and absolute counts of peripheral lymphocyte subsets were measured by flow cytometry. Multivariate logistic regression was used to identify the predictive factors for IVIG-resistant KD and to construct a predictive scoring system for predicting IVIG-resistant KD. Results The multivariate logistic regression analysis showed that CD4+ T cell absolute count, natural killer cell absolute count, serum sodium level, globulin level, and total bilirubin level were identified as predictive factors for IVIG-resistant KD (P<0.05). The predictive scoring system based on these factors achieved a sensitivity of 70.7% and a specificity of 83.8% in predicting IVIG-resistant KD. Conclusions Peripheral blood lymphocyte subsets can serve as predictive indicators for IVIG-resistant KD in children. The introduction of this indicator and the establishment of a scoring system based on it can provide a higher accuracy in predicting IVIG-resistant KD in children.

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	Articles by authors
	XUE Yan
	YIN Jing
	XU Li
	DANG Li-Heng
	WANG Chao
	CUI Ya-Qiong
	ZHANG Xin-Jie
	LI Chong-Wei

Key words： Kawasaki disease Peripheral blood lymphocyte subsets Resistance to intravenous immunoglobulin Scoring system Child

Received: 17 May 2023

Cite this article:

XUE Yan,YIN Jing,XU Li et al. Predictive value of peripheral blood lymphocyte subsets for children with intravenous immunoglobulin-resistant Kawasaki disease[J]. CJCP, 2023, 25(12): 1211-1218.

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http://www.zgddek.com/EN/10.7499/j.issn.1008-8830.2305067 OR http://www.zgddek.com/EN/Y2023/V25/I12/1211

	Brogan P, Burns JC, Cornish J, et al. Lifetime cardiovascular management of patients with previous Kawasaki disease[J]. Heart, 2020, 106(6): 411-420. PMID: 31843876. PMCID: PMC7057818. DOI: 10.1136/heartjnl-2019-315925.
	陕西省川崎病诊疗中心, 陕西省儿童内科疾病临床医学研究中心, 陕西省人民医院儿童病院, 等. 静脉输注免疫球蛋白在儿童川崎病中应用的专家共识[J]. 中国当代儿科杂志, 2021, 23(9): 867-876. PMID: 34535199. PMCID: PMC8480171. DOI: 10.7499/j.issn.1008-8830.2107110.
	Ae R, Abrams JY, Maddox RA, et al. Corticosteroids added to initial intravenous immunoglobulin treatment for the prevention of coronary artery abnormalities in high-risk patients with Kawasaki disease[J]. J Am Heart Assoc, 2020, 9(17): e015308. PMID: 32811256. PMCID: PMC7660775. DOI: 10.1161/JAHA.119.015308.
	Hamada H, Suzuki H, Onouchi Y, et al. Efficacy of primary treatment with immunoglobulin plus ciclosporin for prevention of coronary artery abnormalities in patients with Kawasaki disease predicted to be at increased risk of non-response to intravenous immunoglobulin (KAICA): a randomised controlled, open-label, blinded-endpoints, phase 3 trial[J]. Lancet, 2019, 393(10176): 1128-1137. PMID: 30853151. DOI: 10.1016/S0140-6736(18)32003-8.
	Hedrich CM, Schnabel A, Hospach T. Kawasaki disease[J]. Front Pediatr, 2018, 6: 198. PMID: 30042935. PMCID: PMC6048561. DOI: 10.3389/fped.2018.00198.
	Noval Rivas M, Lee Y, Wakita D, et al. CD8+ T cells contribute to the development of coronary arteritis in the Lactobacillus casei cell wall extract-induced murine model of Kawasaki disease[J]. Arthritis Rheumatol, 2017, 69(2): 410-421. PMID: 27696768. PMCID: PMC5274597. DOI: 10.1002/art.39939.
	Xie Z, Huang Y, Li X, et al. Atlas of circulating immune cells in Kawasaki disease[J]. Int Immunopharmacol, 2022, 102: 108396. PMID: 34890998. DOI: 10.1016/j.intimp.2021.108396.
	8 熊晓, 余理, 冯园, 等. 淋巴细胞亚群在儿科临床的应用[J]. 中华临床免疫和变态反应杂志, 2022, 16(5): 504-510. DOI: 10.3969/j.issn.1673-8705.2022.05.010.
	McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association[J]. Circulation, 2017, 135(17): e927-e999. PMID: 28356445. DOI: 10.1161/CIR.0000000000000484.
	Kobayashi T, Inoue Y, Takeuchi K, et al. Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease[J]. Circulation, 2006, 113(22): 2606-2612. PMID: 16735679. DOI: 10.1161/CIRCULATIONAHA.105.592865.
	Egami K, Muta H, Ishii M, et al. Prediction of resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease[J]. J Pediatr, 2006, 149(2): 237-240. PMID: 16887442. DOI: 10.1016/j.jpeds.2006.03.050.
	Sano T, Kurotobi S, Matsuzaki K, et al. Prediction of non-responsiveness to standard high-dose gamma-globulin therapy in patients with acute Kawasaki disease before starting initial treatment[J]. Eur J Pediatr, 2007, 166(2): 131-137. PMID: 16896641. DOI: 10.1007/s00431-006-0223-z.
	Yang S, Song R, Zhang J, et al. Predictive tool for intravenous immunoglobulin resistance of Kawasaki disease in Beijing[J]. Arch Dis Child, 2019, 104(3): 262-267. PMID: 30026252. DOI: 10.1136/archdischild-2017-314512.
	Wu S, Liao Y, Sun Y, et al. Prediction of intravenous immunoglobulin resistance in Kawasaki disease in children[J]. World J Pediatr, 2020, 16(6): 607-613. PMID: 32232677. DOI: 10.1007/s12519-020-00348-2.
	Lo MS. A framework for understanding Kawasaki disease pathogenesis[J]. Clin Immunol, 2020, 214: 108385. PMID: 32173601. DOI: 10.1016/j.clim.2020.108385.
	Matsuguma C, Wakiguchi H, Suzuki Y, et al. Dynamics of immunocyte activation during intravenous immunoglobulin treatment in Kawasaki disease[J]. Scand J Rheumatol, 2019, 48(6): 491-496. PMID: 31272272. DOI: 10.1080/03009742.2019.1604992.
	Zhang C, Zhang X, Shen J, et al. Changes in peripheral blood neutrophils, lymphocytes and IL-10 in children with Kawasaki disease from different age groups undergoing intravenous immunoglobulin: a retrospective study[J]. Mediators Inflamm, 2020, 2020: 5213451. PMID: 33293897. PMCID: PMC7691014. DOI: 10.1155/2020/5213451.
	Ding Y, Li G, Xiong LJ, et al. Profiles of responses of immunological factors to different subtypes of Kawasaki disease[J]. BMC Musculoskelet Disord, 2015, 16: 315. PMID: 26497060. PMCID: PMC4619387. DOI: 10.1186/s12891-015-0744-6.
	Burns JC, Hsieh LE, Kumar J, et al. Characterization of circulating immune cells in acute Kawasaki disease suggests exposure to different antigens[J]. Clin Exp Immunol, 2020, 202(3): 263-272. PMID: 32812215. PMCID: PMC7670149. DOI: 10.1111/cei.13506.
	20 黎璇, 钱为国, 钱光辉, 等. 661 例川崎病急性期淋巴细胞亚群变化分析[J]. 中国血液流变学杂志, 2019, 29(2): 155-157. DOI: 10.3969/j.issn.1009-881X.2019.02.008.
	Choi IS, Lee MJ, Choi SA, et al. Circulating immune cell profile and changes in intravenous immunoglobulin responsiveness over the disease course in children with Kawasaki disease[J]. Front Pediatr, 2022, 9: 792870. PMID: 35186822. PMCID: PMC8855096. DOI: 10.3389/fped.2021.792870.
	李娜, 穆亚平, 陈静, 等. 淋巴细胞亚群绝对计数对儿童难治性肺炎支原体肺炎的早期预测作用[J]. 中国当代儿科杂志, 2019, 21(6): 511-516. PMID: 31208501. PMCID: PMC7389588. DOI: 10.7499/j.issn.1008-8830.2019.06.003.