Abstract 【Objective】 To investigate the relationship between Aspartate transaminase (AST)/alanine aminotransferase (ALT) and non response of intravenous immunoglobulin and coronary artery lesion (CAL) in children with Kawasaki disease (KD). 【Methods】 A total of 218 children with KD admitted to Xianyang Rainbow Hospital from June 2018 to May 2021 were selected. According to the treatment status of IVIG,the children were divided into a sensitive group (those who were initially effective in IVIG) and a non responsive group (those who were unresponsive to IVIG treatment). AST,ALT,and AST/ALT were compared between the two groups. KD patients were divided into occurrence and non occurrence groups based on whether they experienced CAL. The influencing factors for the occurrence of CAL in KD patients were analyzed,and the efficacy of AST/ALT in predicting the occurrence of CAL in KD patients was evaluated using the receiver operating characteristic (ROC) curve. 【Results】 The ALT level in the unresponsive group was higher than that in the sensitive group,while AST/ALT was lower than that in the sensitive group,with a statistically significant difference (P<0.05). After 8 weeks of treatment,the incidence of CAL in KD patients was 22.48% (49/218). The duration of fever before IVIG treatment,the ratio of IVIG unresponsive types,PCT,ALT in the occurrence group were higher than those in the non occurrence group (P<0.05),while AST/ALT was lower than those in the non occurrence group (P<0.05). The results of multivariate logistic analysis showed that IVIG treatment without response,ALT,and AST/ALT were all influencing factors for the occurrence of CAL in children with KD (P<0.05). The Receiver operating characteristic analysis showed that the best cut-off point for AST/ALT to assess the incidence of CAL in KD children was 0.63,and the sensitivity,specificity and AUC were 83.67%,68.05% and 0.803,respectively. 【Conclusion】 ALT is higher in IVIG unresponsive KD patients,while AST/ALT is lower. AST/ALT has a higher clinical value in predicting the occurrence of CAL in KD patients.
GUO Xiao-jun,GAO Dong-lian. The Correlation between AST/ALT and Unresponsiveness to Intravenous Immunoglobulin and Coronary Artery Lesion in Children with Kawasaki Disease[J]. JOURNAL OF CLINICAL RESEARCH, 2023, 40(6): 830-833.
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2023, Vol. 40 
