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Diagnostic significance of N-terminal pro-brain natriuretic peptide in acute phase of incomplete Kawasaki disease

??Objective To observe the changes of the plasma level of N-terminal pro-brain natriuretic peptide??NT-proBNP?? in the acute phase of incomplete Kawasaki disease??IKD????and explore its value in the diagnosis of IKD??and then further study its value in predicting IVIG non-responsiveness. Methods The plasma level of NT-proBNP and other laboratory data??including white blood cell??WBC?? count??proportion of neutrophils??N%????platelet??PLT?? count??CRP??ESR??alanine aminotransferase??ALT????aspartate aminotransferase??AST?? and albumin??were detected in 129 children with IKD and 110 children with typical Kawasaki disease??TKD?? in Department of Pediatrics??Tongji Hospital Tongji Medical College??Huazhong University of Science and Technology from Jul.2013 to Dec.2014. A total of 65 children with respiratory tract infection were selected as the control group. The differences among the three groups were analyzed by ANOVA. Meanwhile??the ROC curve analysis was used to evaluate the diagnostic value of NT-proBNP and the other laboratory items with statistically significant differences. Comparisons were finally made. All the Kawasaki disease patients received IVIG 2g/kg and oral aspirin after admission. The t-test was used to compare the difference between the IVIG-non-responsive group and the IVIG-responsive group. Results The level of NT-proBNP in IKD group??796.24±1324.26?? ng/L?? was significantly higher than that in the control group??168.85±208.24?? ng/L??P??0.05????but had no significant difference compared with TKD??1362.70±2576.49?? ng/L??. The area under the ROC curve of NT-proBNP in diagnosis of Kawasaki disease was 0.786. At the optimal cutoff point of 191.5 ng/L??sensitivity and specificity were 70.0%and 76.9%??respectively. The results were similar to albumin??WBC count??CRP and ESR. The NT-proBNP level of IVIG-non-responsive group and the IVIG-responsive group were ??1215.15±1663.33?? ng/L and ??1043.66±2056.45?? ng/L??respectively. The difference was not statistically significant. Conclusion The plasma level of NT-proBNP significantly increases in the acute phase of IKD. It can be used as a useful reference index in the early diagnosis of IKD??but it is of no help to the early prediction of IVIG non-responsiveness.