Value of NT-proBNP,PA and Hs-CRP for Early Recognition of Kawasaki Disease in Febrile Children

HU Ting; CHEN Hailong

doi:10.14033/j.cnki.cfmr.2025.25.018

Abstract：Objective:To evaluate the combined diagnostic value of amino-terminal pro-brain natriuretic peptide precursor(NT-proBNP),prealbumin(PA),and hypersensitive C-reactive protein(hs-CRP)in the early recognition of Kawasaki disease in febrile children.Method:This retrospective study included clinical data from 62 febrile children treated in the hospital from January 2021 to October 2024.31 children diagnosed with Kawasaki disease(observation group)were compared with 31 children suffering from common cold-induced fever(control group).General clinical data,levels of NT-proBNP,PA and hs-CRP were compared between the two groups.The predictive factors for the early identification of Kawasaki disease in children with fever were analyzed.Binary logistic regression analysis was conducted,with fever duration,NT-proBNP,PA,and hs-CRP as independent variables,and Kawasaki disease as the dependent variable,to assess the combined predictive value of these biomarkers.Receiver operating characteristic(ROC)curves were plotted for further evaluation.Result:Compared to the control group,the observation group exhibited significantly longer fever duration,higher NT-proBNP and hs-CRP levels,and lower PA levels(P<0.05).Elevated NT-proBNP and hs-CRP levels were identified as independent risk factors for Kawasaki disease in febrile children,whereas higher PA levels were found to be protective(P<0.05).The combined area under the curve(AUC)for NT-proBNP,PA,and hs-CRP for the early detection of Kawasaki disease was 0.844(95%CI:0.775～0.913),0.759(95%CI:0.681～0.837),0.840(95%CI:0.775～0.908),and 0.873(95%CI:0.799～0.928),with sensitivities of 82.55%,80.88%,76.47%and 84.93%,and specificities of 76.48%,62.06%,74.24%,and 77.92%,respectively.Conclusion:The combination of NT-proBNP,PA and hs-CRP demonstrates high predictive value for the early recognition of Kawasaki disease in febrile children.This multi-biomarker approach could facilitate prompt diagnosis and intervention.