Kuo Ho-Chang, Liu Shih-Feng, Lin Pin-Xing, Yang Kuender D, Lin Bor-Shyh
Kawasaki Disease Center and Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
Children (Basel). 2022 Feb 22;9(3):299. doi: 10.3390/children9030299.
Background: Kawasaki disease (KD) is a form of systemic vasculitis that mainly affects children under the age of five years old. Limb swelling and redness are among the primary symptoms of KD. Previous studies have reported that wireless optical monitoring systems can identify limb indurations characteristics in patients with KD. Therefore, we conducted this study to monitor the dynamic changes in different stages of KD and the disease outcome of coronary artery lesions (CAL).Methods: KD patients who were admitted for intravenous immunoglobulin (IVIG) treatment and controls with or without fever were enrolled in this study. Near infrared spectroscopy data were collected for KD patients at different stages, including before (within one day before IVIG treatment, KD1) and shortly after IVIG treatment (within three days, KD2), at least 21 days after IVIG (KD3), 6 months later (KD4), 1 year later (KD5), 2 years later (KD6), and 3 years later (KD7).Results: This study included a total of 350 pieces of data, including data from 20 healthy controls, 64 fever controls, 53 KD1, 67 KD2, 58 KD3, 28 KD4, 25 KD5, 15 KD6, and 20 KD7. The relative HbO2 of the KD1 group were significantly lower than those of the healthy group (0.298 ± 0.01 vs. 0.304 ± 0.05, p = 0.028) but no significant differences were found with the fever group. The HbT concentrations of KD1 group showed significantly lower than health group (0.632 ± 0.019 vs. 0.646 ± 0.021, p = 0.001) but no significant difference with fever control. Relative levels of HbO2, HbT and Hb showed significant difference between KD1 and health control while StO2 and H2O showed difference between KD1 and fever control. The relative H2O concentration was significantly higher in KD patients with CAL formation than without (p < 0.005). Conclusion: This report is the first to use near infrared spectroscopy to detect changes in tissue hemoglobin and water levels at different stages of KD in patients and showed that water content was significantly associated with CAL formation. This non-invasive device may benefit physicians by serving for early identification of KD from fever illness.
川崎病（KD）是一种系统性血管炎，主要影响五岁以下儿童。肢体肿胀和发红是KD的主要症状之一。既往研究报道，无线光学监测系统可识别KD患者的肢体硬结特征。因此，我们开展本研究以监测KD不同阶段的动态变化及冠状动脉病变（CAL）的疾病转归。
本研究纳入接受静脉注射免疫球蛋白（IVIG）治疗的KD患者以及有或无发热的对照组。收集KD患者不同阶段的近红外光谱数据，包括IVIG治疗前（IVIG治疗前1天内，KD1）、IVIG治疗后不久（3天内，KD2）、IVIG治疗后至少21天（KD3）、6个月后（KD4）、1年后（KD5）、2年后（KD6）和3年后（KD7）。
本研究共纳入350份数据，包括20名健康对照、64名发热对照、53名KD1、67名KD2、58名KD3、28名KD4、25名KD5、15名KD6和20名KD7的数据。KD1组的相对HbO2显著低于健康组（0.298±0.01对0.304±0.05，p = 0.028），但与发热组无显著差异。KD1组的HbT浓度显著低于健康组（0.632±0.019对0.646±0.021，p = 0.001），但与发热对照无显著差异。KD1组与健康对照之间HbO2、HbT和Hb的相对水平有显著差异，而KD1组与发热对照之间StO2和H2O有差异。有CAL形成的KD患者的相对H2O浓度显著高于无CAL形成的患者（p < 0.005）。
本报告首次使用近红外光谱检测KD患者不同阶段组织血红蛋白和水分水平的变化，并表明水分含量与CAL形成显著相关。这种非侵入性设备可能有助于医生从发热性疾病中早期识别KD。
