Correlation of heart rate variability and procalcitonin, high sensitivity C-reactive protein in children with Kawasaki disease in the acute stage / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the relationship of heart rate variability (HRV) and procalcitonin (PCT),high sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate (ESR) in children with Kawasaki disease (KD) in the acute stage,and to investigate their value in diagnosis and prognosis of KD especially incomplete KD (iKD).Methods Two hundred and twenty patients with KD in Chengdu Women and Children's Central Hospital from August 2012 to October 2015 were selected.According to the diagnostic criteria,patients with KD were divided into a typical KD group and an iKD group.According to the status of coronary artery damage,the patients with KD were divided into coronary artery lesion (CAL) group and no coronary artery lesion(NCAL) group.Another 100 healthy children were selected as healthy control group.All the children received 24 h dynamic electrocardiogram and were given tests of blood PCT,hs-CRP and ESR.The differences of HRV,PCT,hs-CRP and ESR between the CAL group and the NCAL group,between the typical KD group and iKD group were compared.The correlations of HRV and PCT,hs-CRP and ESR were analyzed.Results Of 220 KD patients,182 cases were in the typical KD group and 38 cases in the iKD group;64 cases in the CAL group and 156 cases in the NCAL group.The mean levels of HRV were lower in KD group than those in healthy control group (all P ＜ 0.05),especially those in the CAL group fell more obviously.The differences in the standard deviation of N-N intervals(SDNN),percent ages of N-N 50 in the total number N-N intervals (PNN50) and low frequency (LF) between the CAL group,the NCAL group and the healthy control group were all statistically significant(all P ＜0.05).The mean levels of HRV,PCT and hs-CRP had no statistically significant difference between typical KD and iKD groups (all P ＞ 0.05).The mean level of ESR had a statistically significant difference between 2 groups (P ＜ 0.05).SDNN was negatively correlated with PCT,hs-CRP and ESR (r =-0.443,-0.364,-0.427,all P ＜ 0.05).Conclusion In patients with KD in the acute stage,the decrease of HRV can be correlated with inflammatory reaction.HRV can be used as valuable predictors for coronary artery lesion in patients with KD,but its help in the early diagnosis of iKD has not found.