川崎病患儿血清肌钙蛋白Ⅰ和C-反应蛋白检测的意义

Clinical significance of cardiac troponin Ⅰ and C-reactive protein in child with Kawasaki disease

目的探讨川崎病(kawasaki disease,KD)患儿静脉注射免疫球蛋白前后心肌肌钙蛋白Ⅰ(cTnⅠ)和C-反应蛋白(CRP)变化的临床意义。方法58例川崎病患儿,其中合并冠状动脉病变者12例,无冠状动脉病变者46例,于静脉注射丙种球蛋白前后采血测定血清肌钙蛋白I、C-反应蛋白。结果合并冠状动脉病变(CAL)组治疗前cTnI、CRP浓度值分别为(1.13±0.27)ng/mL和(66.63±17.13)mg/L,与其治疗后cTnI(0.93±0.08)ng/mL,CRP(59.58±13.97)mg/L比较差异无显著性(P>0.05);无冠状动脉损伤(NCAL)组治疗前cTnI、CRP浓度值分别为(0.66±0.23)ng/mL、(40.52±7.10)mg/L,与治疗后cTnI(0.15±0.16)ng/mL,CRP(17.85±4.43)mg/L比较差异有显著性(P<0.05)。川崎病患儿急性期血清肌钙蛋白I浓度与CRP呈正相关(r=0.731,P<0.01)。结论血清肌钙蛋白Ⅰ和C-反应蛋白检测可为川崎病合并冠状动脉病变的诊断提供重要参考,动态检测cTnI、CRP有助于KD静脉注射丙种球蛋白治疗效果及预后判断。

[Objective] To probe the clinical significance of the cardiac troponin Ⅰ and C-reactive protein in Kawasaki disease （KD） treated with intravenous immunoglobulin （IVIG）. [Methods] cTnI and CRP were detected in 58 cases of KD before and after treatment with IVIG. Which conclude 12 cases of coronary artery lesion （CAL） and 46 cases of none coronary artery lesion （NCAL）. [Results] There was no significant difference in the serum cTnI and CRP between the CAL group before and after treatment with IVIG, （P 〉0.05）. cTnI and CRP in NCAL group before without IVIG treatment were respectively （0.66±0.23） ng/mL, （40.52±7.10） mg/L, significandy higher than that treatment with IVIG group [（0.15±0.16） ng/mL, （17.85±4.43） mg/L, P 〈0.05.] Linear regression analysis showed that the level of cTnI closely correlated with CRP level （r=-0.731, P〈0.01）. [Conclusion] The detection of cTnI and CRP may be useful serologic test for early diagnosis of KD coronary artery lesion, and can be used as an index to evaluate the effect of treatment with IVIG.