川崎病患儿血浆中血栓前体蛋白的变化及意义

The significance for changes of plasma thrombus precursor protein in children with Kawasaki Disease

目的探讨血浆血栓前体蛋白(TPP)水平在川崎病(KD)患儿中的变化及其意义。方法2008年3月至9月山西省儿童医院心内科收治并确诊为KD的住院患儿40例,根据超声心动图显示分为冠状动脉损伤(CAL)组(16例),非冠状动脉损伤(NCAL)组(24例);根据病程分为急性期组和恢复期组。另以20名健康儿童作为健康对照组。应用酶联免疫吸附法检测血浆TPP水平。结果KD组患儿急性期血浆TPP含量高于恢复期及对照组,急性期和恢复期及对照组比较差异有统计学意义(P<0.05);KD恢复期与对照组相比差异有统计学意义(P<0.05)。KD急性期CAL组TPP含量与NCAL组相比,两者差异有统计学意义(P<0.05)。KD恢复期CAL组TPP含量与NCAL组相比,两者差异无统计学意义(P>0.05)。KD组患儿急性期TPP含量与冠状动脉扩张呈正相关,相关系数和P值分别为r=0.825,P<0.05。结论川崎病患儿急性期血浆中TPP浓度升高可能反映了KD患儿血液存在血栓前高凝状态,其含量变化可能与冠状动脉的损伤及其程度有一定的相关性。

Objective To explore the change of plasma TPP levels in patients with Kawasaki disease （KD） and its clinical significance. Methods To collect forty cases of Kawasaki disease in the department of cardiology in Shanxi Province Children＇s Hospital, including twenty-seven boys and thirteen girls. According to echocardiogram, these cases were divided into coronary artery lesion group （sixteen cases） and non-coronary artery lesion group （twenty-four cases）. According to the course of development, this was divided into acute and convalescent phase. Normal control group： twenty cases of normal children who went to the hospital for health examination, including twelve boys and eight girls. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of TPP in the plasma. Results TPP level in acute phase was higher than that in normal control group and convalescent phase; both had statistical significance （P 〈0.05）. There was statistical significance between convalescent phase and normal control group （P 〈 0.05）. Compared with non-coronary artery lesion group in acute phase, coronary artery lesion group had statistical significance in TPP （P 〈 0.05）. There was not statistical significance between coronary artery lesion and non-coronary artery lesion in convalescent phase. Thrombus precursor protein had positive relation with coronary artery dilation in Kawasaki disease （r = 0.825, P 〈 0.05）. Conclusion TPP level was increased significantly in acute phase of Kawasaki disease. It can be looked as an index for hypercoagulable state. The change of TPP in Kawasaki disease had a relationship with coronary artery lesion.