川崎病患儿血浆中抗β_2糖蛋白1抗体水平及其临床意义

The level and clinical value of anti-beta 2-glycoprotein 1 antibodies in the plasma of children with Kawasaki diseases

目的探讨川崎病(KD)患儿血浆中抗β2糖蛋白1(β2GP1)抗体水平及其临床意义。方法采用ELISA法检测20例KD患儿血浆中抗β2GP1抗体水平,并与正常儿童组对照。结果20例KD患儿,临床诊断时间平均9.8d,冠状动脉扩张(CAD)发生率60%(12/20),冠状动脉瘤(CAA)发生率25%(5/20)。抗β2GP1抗体阳性15例,阳性率为75%(15/20),抗β2GP1抗体水平用A492值表示为0.909±0.310,正常对照组A492值为0.351±0.154,两者比较有显著性差异(t=6.566,P﹤0.001)。12例CAD患儿A492为1.119±0.1,8例无CAD患儿A492为0.593±0.24,二者比较有显著性差异(t=2.404,P﹤0.05)。结论KD患儿血浆中存在高水平的抗β2GP1抗体,并发冠脉损伤的KD患儿抗β2GP1抗体水平明显高于未并发冠脉损伤的患儿。提示抗β2GP1抗体是KD冠状动脉损伤的一种重要危险因子。

Objective To explore the level and clinical value of anti-beta 2-glycoprotein 1 antibodies （β2GP1） in the plasma of children with Kawasaki diseases（KD）. Methods Enzyme-linked immunosorbent assay（ELISA） for an anti-β2GP1 antibodies was established to analyze the plasma of 20 KD children, as well as 16 health children. Results Coronary artery dilatation （CAD） and Coronary artery aneurysms （CAA） were reported in 12/20 patients and 5/20 patients. The positive rate of anti-β2GP1 antibodies in the KD group was 75%（15/20）. There was significant difference in the level of anti-β2GP1 antibodies between patients with KD （A 492：0.909±0.310） and healthy children （A 492：0.351±0.154）, P 〈 0.001, t=6.566. The anti-β2GP1 antibodies was signifieandy higher in patients with CAD （A492：1.119±0.1, n=12） than in those without （A492：0.593±0.24, n=8）, P 〈 0.05, t=2.404. Conclusions The level of anti-β2GP1 antibodies is slsvated in KD group, and is significantly higher in children with coronary artery lesions （CAL） comparing with the children without CAL. The results suggest that anti-β2GP1 antibodies are strongly associated with KD, and is an important risk indicator of KD developing CAL.