Comparison of N-terminal pro-brain natriuretic peptide and echocardiography in the early diagnosis of Kawasaki disease / 中华实用儿科临床杂志

ABSTRACT

Objective@#To compare the differences between roles of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and that of echocardiography in early diagnosis of Kawasaki disease (KD).@*Methods@#Medical records of patients with KD at the Department of Pediatrics, Fujian Provincial Hospital from January 2013 to December 2017 were collected retrospectively.The levels of NT-proBNP and the echocardiographic parameters on admission were compared between patients with varying days of fever by the Chi-squared test.@*Results@#A total of 154 patients with typical KD (TKD) were identified.Among them, 104 cases had fever ≤7 days on admission, 90 cases out of them with NT-proBNP≥300 ng/L, 14 cases with coronary artery lesion detected by echocardiography, and 13 cases with positive findings in both NT-proBNP and echocardiography.For patients having ≤7 days of fever, the positive rate of NT-proBNP value was significantly higher than that of echocardiographic examination (χ2=74.05, P<0.05). Forty-four cases had 8-11 days of fever, and among them 7 cases with NT-proBNP≥300 ng/L, 8 cases with coronary artery lesion, 3 cases with two indexes positive.For patients with 8-11 days of fever, there was no significant difference in the positive rate between NT-proBNP and echocardiography (χ2=0, P>0.05). Among 6 total cases who had 12-21 days of fever, 3 cases had coronary artery lesion, none with NT-proBNP≥300 ng/L.For patients with 12-21 days of fever, there was no significant difference in the positive rate between NT-proBNP and echocardiography (χ2=0, P>0.05). A total of 102 cases with incomplete KD (IKD) were enrolled, and among them of 69 cases had fever ≤7 days on admission, 56 cases with NT-proBNP≥300 ng/L, 6 cases with coronary artery lesion, and 6 cases with positive findings in both indexes.For IKD patients with ≤7 days of fever, the positive rate of NT-proBNP value was significantly higher than that of echocardiographic examination (χ2=50.00, P<0.05). Twenty-nine cases had 8-11 days of fever, and among them 5 cases with NT-proBNP≥300 ng/L, 4 cases with coronary artery lesion.For IKD patients with 8-11 days of fever, there was no significant difference in the positive rate between NT-proBNP and echocardiography (χ2=0, P>0.05). In cases with 12-21 days of fever, 2 cases had coronary artery lesion, none with NT-proBNP ≥300 ng/L.Echocardiography revealed coronary artery lesions in 2 cases.For patients with 12-21 days of fever, there was no significant difference in the positive rate between NT-proBNP and echocardiography (χ2=0, P>0.05).@*Conclusions@#Higher levels of NT-proBNP can be helpful for early diagnosis of KD in children, which is a better predictor than echocardiography.