Objective To investigate the clinical application value of human cartilage glycoprotein-39 (YKL-40) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in coronary artery injury (CAL) children with Kawasaki disease (KD).

Methods A total of 125 children with KD were selected as study subjects (KD group), and divided into CAL group (n=53) and no coronary artery injury (NCAL) group (n=72) according to whether they were complicated with coronary artery disease. Healthy children who underwent physical examination during the same period (HC group) and only the digestive tract infection of children with fever in the same period (FC group) in the hospital were selected as control. Plasma levels of YKL-40 and NT-proBNP were measured. Receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of YKL-40 and NT-proBNP in CAL at different periods of KD children.

Results Plasma YKL-40 and NT-proBNP levels in KD children were significantly higher than those in the HC group and the FC group at different periods (acute stage, subacute stage and recovery stage) (P < 0.05). YKL-40 level in the CAL group was significantly higher than that in the NCAL group, and NT-proBNP in acute stage was significantly higher than that in the NCAL group (P < 0.05). The area under the curve (AUC) of YKL-40, NT-proBNP and their combination in diagnosing CAL in acute period of KD were 0.813, 0.832 and 0.886, respectively; the AUC of YKL-40, NT-proBNP and their combination in the diagnosis of KD subacute CAL were 0.699, 0.522 and 0.701, respectively; the AUC of YKL-40, NT-proBNP and their combination in diagnosing coronary artery injury during KD convalesce were 0.982, 0.435 and 0.986, respectively.

Conclusion Plasma YKL-40 and NT-proBNP levels can be used as early diagnostic indicators for KD. Plasma YKL-40 can be used in combination with other indicators to monitor KD disease activity and the development of complications from coronary artery injury.