川崎病患儿血清降钙素原和白介素-6质量浓度变化及其与并发症的关系

The study of serum procalcitonin and interleukin-6 levels in children with Kawasaki disease

目的观察川崎病(KD)患儿血清降钙素原(PCT)、白介素-6(IL-6)水平的变化,探讨其与KD并发症间的关系。方法研究对象为2003-10—2005-12在首都儿科研究所附属儿童医院住院的88例KD患儿,测定其血清PCT、IL-6水平;正常对照为同期33例健康儿童,进行同样检测。结果(1)71例急性期患儿PCT水平与14例亚急性期患儿、33例正常对照儿童PCT水平相比,其差异均有统计学意义(P<0.05和<0.01)。(2)急性期24例其他系统并发症患儿PCT水平显著高于47例无其他系统并发症患儿,且差异有统计学意义(P<0.01);当PCT≤0.5ng/mL时,其他系统并发症发生率16.3%;当PCT>0.5时,其他系统并发症发生率41.0%,两者差异有统计学意义(P<0.05)。(3)56例急性期患儿IL-6水平与11例亚急性期患儿、14例正常对照儿童IL-6水平相比,其差异均有统计学意义(P值均<0.01)。(4)急性期17例其他系统并发症患儿IL-6水平显著高于39例无其他系统并发症患儿IL-6水平,二者差异有统计学意义(P<0.01)。结论(1)KD患儿急性期血清PCT、IL-6水平增高,亚急性期下降,PCT增高维持时间较IL-6稍长。(2)血清PCT、IL-6水平在发生其他系统并发症患儿中是显著升高的,对其检测有助于KD的病情评价。

Objective To study the changes of serum PCT and IL-6 levels in Kawasaki disease （ KD ） patients, and evaluate the relationships of them with complications. Methods Totally 88 KD patients and 33 healthy children were recruited in this study. KD patients were divided into different groups. Serum PCT and IL-6 concentrations of KD patients were compared with healthy children, and compared within different groups. Results （ 1 ） Serum PCT concentrations of acute patients were significantly higher than subacute patients and healthy children ,0. 55 （0. 30 ～ 1.81 ） ng/ml vs. 0. 49 （ 0. 20 ～ 0. 50 ） ng/ml（ P 〈 0. 05 ） and 0. 55 （ 0. 30 ～ 1.81 ） ng/ml vs. 0. 16 （ 0. 14 ～ 0. 24 ） ng/ml（ P 〈 0. 01 ）. （ 2 ） Serum concentrations of PCT were significantly higher in acute patients with noncardiac complication as compared to those without noncardiac complication, 1.67 （0.49 ～ 4. 14 ） ng/rnl vs. 0. 47 （ 0. 27 ～ 0. 74 ） ng/ml （ P 〈 0. 01 ）. Noncardiac complications occurred in 16. 3% （8/41） acute patients if PCT levels were ≤0. 5ng/mL, and the incidence increased to 41.0% （16/23） ifPCT levels were 〉 0.5ng/mL, X^2 = 6. 68（ P 〈0.05）. （3） Serum IL-6 concentrations of acute patients were significantly higher than subacute patients and healthy children, 43.34 （ 13.67 ～ 132. 72 ） pg/ml vs. 8.62 （7.56 ～ 56. 54 ） pg/ml （ P 〈 0. 01 ） , and 43.34 （ 13.67 ～ 132. 72 ） pg/ml vs. 8. 80 （6.00 ～ 13.05 ） pg/ml （ P 〈 0. 01 ）. （4） Significantly higher serum IL-6 concentrations were shown in acute patients with noncardiac complication than those without noncardiac complication, 110. 97 （ 21.00 ～ 148. 79 ） pg/ml vs. 26. 13 （ 9. 34 ～ 78. 84 ） pg/ml, P 〈 0. 01. Conclusion （ 1 ） There is significant elevation of serum PCT and IL-6 concentrations in all KD patients, and the concentrations of them gradually decreased with the development of KD. High levels of PCT can last longer than those of IL-6. （ 2 ） Significantly high serum PCT and IL-6 concentrations were observed in KD patients with noncardiac complications, and it may be a useful index for evaluating KD patients.