Relationship between serum syndecan-1,angiotensin-converting enzyme 2 and coronary artery lesions in chil-dren with Kawasaki disease and clinical efficacy

WANG Cong-gui; PENG Hai-lin; XIONG Wei

doi:10.13820/j.cnki.gdyx.20234007

Abstract：Objective To investigate the relationship between serum syndecan-1(SDC-1),angiotensin-converting enzyme 2(ACE2),coronary artery lesions(CAL),and clinical efficacy in children with Kawasaki disease(KD).Methods A total of 113 children with acute KD from June 2020 to March 2022 were enrolled as the KD group.Ultrasonic echocardiography was performed before treatment,and patients were divided into the CAL group(n=39)and non-CAL group(n=74)based on the results.Additionally,60 healthy children who underwent physical examinations at the same period were included as the control group.Clinical data were collected,and serum levels of SDC-1 and ACE2 were detected using enzyme-linked immunosorbent assay.After treatment,efficacy assessment was conducted,with pa-tients classified into the effective treatment group(n=89)and ineffective treatment group(n=24).Multifactor logistic regression analysis was used to identify factors influencing treatment ineffectiveness,and receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of serum SDC-1,ACE2,and their combination for treatment ineffectiveness.Results Serum levels of SDC-1 and ACE2 in the KD group were significantly higher than those in the control group(P＜0.05).The CAL group had higher serum levels of SDC-1 and ACE2 as compared to the non-CAL group(P＜0.05).There were significant differences in fever duration,procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6),SDC-1,and ACE2 levels between the effective treatment group and ineffective treatment group(P＜0.05).Multifactor logistic regression analysis revealed that PCT,CRP,IL-6,SDC-1,and ACE2 were significant factors influencing treatment ineffectiveness in children with KD(P＜0.05).ROC curve analysis showed that the combined prediction of serum SDC-1 and ACE2 for treatment ineffectiveness had an area under the ROC curve(AUC)of 0.837(95％CI:0.726-0.926),which was higher than that of individual tests.The combined predic-tion of serum SDC-1,ACE2,PCT,CRP,and IL-6 for treatment ineffectiveness had an AUC of 0.903(95％CI:0.861-0.912),indicating improved predictive value compared to the combined SDC-1 and ACE2 test alone.Conclu-sion Elevated serum levels of SDC-1 and ACE2 in children with KD are associated with a higher risk of CAL and poorer clinical efficacy.Combined detection of SDC-1 and ACE2 has good predictive value for clinical efficacy.