CRP、Ig和心肌酶学变化与川崎病患者冠状动脉损伤的关系

The relationship between C-reaction protein and immunoglobulin with coronary aretery lesions and the change of myocardiac enzymology in children with Kawasaki disease

目的探讨血清C反应蛋白(CRP)和免疫球蛋白(IgG、IgA、IgM)与川崎病患者冠状动脉损伤及心肌酶谱(包括CK、CK-MB、AST、LDH和HBDH)变化的关系。方法对45例川崎病患儿在治疗前和治愈后进行血清CRP、IgG、IgA、IgM和心肌酶学检测,并通过心脏彩色多谱勒超声检查明确患儿冠状动脉损伤情况。结果川崎病患儿在急性发病时血清CRP、IgG、IgM、和CK-MB水平明显升高,治愈后上述指标基本恢复到正常水平。伴有冠状动脉损伤的川崎病患儿血清CRP、IgG、和IgM水平明显高于没伴有冠状动脉损伤的患儿。血清CRP、IgG和IgM水平与CK-MB水平呈显著正相关关系。结论川崎病患儿血清CRP、IgG和IgM的升高与患儿急性炎症反应程度密切相关,同时也可作为预测患儿心肌损伤及冠状动脉病变的重要参考指标。

Objective To explore the correlation of serums C reaction protein（CRP） and immunoglobulin with coronary artery lesions and the change of myocardiac enzymology in children with Kawasaki disease. Methods The levels of serum CRP, immunoglobulin（ IgG, IgA, IgM） and myocardiac enzymology （ CK, CK - MB, AST, LDH and HBDH） were detected in 45 children with Kawasaki disease before treatment and after treatment. The coronary artery was checked by Doppler echocardiography in 45 cases. Results In acute phase, the levels of serum CRP, IgG, IgM and CK - MB in patients with Kawasaki disease were significantly higher than tha of the control group. After treatment, the levels of serum CRP, IgG, IgM and CK - MB in patients with Kawasaki disease were returned to normal. The levels of serum CRP, IgG and IgM in patients with coronary artery lesions were significantly higher than that of none. The levels of serums CRP, IgG, IgM were associated with the level of serum CK - MB. Conclusion The levels of serums CRP, IgG and IgM not only may are closedly assocaited with the degree of inflammation reaction and these can be taken as the indicators for diagnosis of myocardiac damage and coronary artery lesions in children with Kawasaki disease.