川崎病患儿治疗前后血清肿瘤坏死因子-α的变化及其意义

Changes of plasma levels of tumor necrosis factor-α (TNF-α) and its value in children with Kawasaki disease before and after treatment

目的:探讨川崎病(KD)患儿静脉注射用丙种球蛋白(IVIG)治疗前后血清肿瘤坏死因子-α(TNF-α)水平变化及其意义。方法:治疗组选择本院确诊KD患儿34例,分为冠状动脉损伤组14例和无冠状动脉损伤组20例;正常对照组选择年龄相仿的门诊体检健康儿童l5例。采用酶联免疫吸附法检测KD患儿经IVIG治疗前后及对照组血清TNF-α水平。结果:KD患儿治疗前急性期血清TNF-α水平明显高于正常对照组(P<0.01);与无冠状动脉损伤组比较,冠状动脉损伤组血清TNF-α水平升高更明显(P<0.05)。经IVIG治疗后KD患儿恢复期血清TNF-α水平明显降低(P<0.01)。结论:血清TNF-α水平在KD患儿急性期、尤其有冠状动脉损伤时明显升高;血清TNF-α可能参与KD冠状动脉损伤的病理过程。

Objective： To explore the change and clinical significance of plasma levels of TNF-α in children with Kawasaki disease （KD） （n = 34） before and after treatment with intravenous immunoglobulin （IVIG） . Methods： Children with KD were enrolled from June 2005 to July 2007, one group （ n = 14） with coronary artery lesions （CALs） and another group （ n = 20） without CALs. The control were enrolled from heathy children in clinic service. Enzyme -linked immunosorbent assay （ELISA） was used to detect the plasma levels of TNF - α in children with KD （ n = 34） before and after treatment with IVIG and in normal control group （ n = 15 ） respectively. Results： The plasma level of TNF - α in KD group before treatment with IVIG was significanly higher than that in control group （P 〈0. 01 ）. Moreover, the plasma level TNF -α in KD with CALa before treatment with IVIG was significantly increased, compared with KD without CALs （ P 〈 0. 05 ）. The plasma level of TNF - α in KD after treatmented with IVIG decreased obviously （ P 〈 0. 01 ） . Condusion： The plasma level of TNF - α in acute stage of KD significantly elevate, especially in KD with CALs. TNF -α may be involved in the formation of CALLs and pathogenesis of KD.