Objective      To determine the roles of serum levels of heme oxygenase-1 (HO-1) and C reactive protein (CRP) in the prediction of coronary artery lesions (CAL) in children with Kawasaki disease (KD).       Methods      Totally 89 children with identified KD admitted in our hospital from March 2013 to May 2014 were enrolled in this study

and were divided into no coronary artery lesion group (NCAL

n=35)

CAL5 mm group (n=44) and CAL≥5 mm group (n=10). Another 34 children with acute febrile diseases (group F

n=34) and 45 normal healthy children (group N

n=45) were also recruited as control. The levels of malondialdehyde (MDA)

HO-1 and superoxide dismutase (SOD) were detected before and after intravenous immunoglobulin (IVIG) treatment respectively. Serum levels of CRP and hemoglobin (Hb) were also enrolled to correlation analysis.       Results      During the acute phase of KD

MDA levels were significantly increased. The levels of HO-1 were significantly higher in CAL 5 mm group than the other 4 groups. The levels of SOD were lower in CAL ≥5 mm group than N group. CRP levels in CAL ≥5 mm group were significantly higher than the other groups. The incidence of CAL was 56.52% (13/23) in 30 KD cases with HO-1 ≥9 ng/mL and CRP ＞44 mg/L

which was significantly higher than that of NCAL (0%

0/7). The incidence of CAL ≥5 mm was 88.89% (8 of 9) in 31 CAL cases with HO-1 9 ng/mL and CRP ＞85 mg/L

which was significantly higher than that of CAL＜5 mm (36.36%

8/22). HO-1 was significantly negatively correlated with Hb level (r=-0.37

P0.05) in CAL group. IVIG treatment resalted in elevated HO-1 and decreased MDA in CAL group but had no change on SOD activity.       Conclusions      Combined analyzing of HO-1 and CRP may predict the occurrence and severity of CAL in the acute phase of KD.