抗β_2糖蛋白1抗体、基质金属蛋白酶9与川崎病相关性及临床意义

Clinical significance of anti-β2 glycoprotein 1 antibody and matrix metalloproteinase-9 and their association with Kawasaki disease

目的观察川崎病急性期患儿血清抗β2糖蛋白1(β2GP1)抗体、基质金属蛋白酶9(MMP-9)水平,探讨其与川崎病相关性及临床意义。方法采用ELISA法检测47例川崎病患儿血清抗β2GP1抗体、MMP-9水平,应用SPSS11.5软件进行数据分析。30例同期住院、年龄相仿的感染性疾病患儿为发热对照组,均除外心、肝、肾、血液及风湿性疾病。结果47例川崎病患儿中并发冠状动脉病变者17例。川崎病组和对照组血清中抗β2GP1抗体水平分别为(7.46±2.13)U/ml和(4.38±0.43)U/ml;MMP-9分别为(886.62±92.72)ng/ml和(460±179.59)ng/ml,两组比较差异均有统计学意义(P均<0.05);川崎病组中冠状动脉损伤与冠状动脉正常患儿血清抗β2GP1抗体分别为(8.83±0.89)U/ml和(6.18±1.42)U/ml,MMP-9分别为(948.62±81.76)ng/ml和(872.00±34.74)ng/ml,两组比较差异均有统计学意义(P均<0.05);川崎病组血清中抗β2GP1抗体、MMP-9水平呈显著正相关(r=0.665,P<0.05)。结论抗β2GP1抗体、MMP-9在川崎病急性期尤其伴冠状动脉病变时明显升高,两者在川崎病发生、发展过程中具有协同作用,是川崎病冠状动脉损伤血清学重要指标。

Objective To explore the levels and clinical significance of anti-beta 2-glycoprotein 1 antibodies （-β2GP1）, matrix metallopmteinase 9 （ MMP-9）in the plasma of children with Kawasaki diseases （KD）. Methods Serum level of anti-β2GP1 antibody and MMP-9 was measured in 47 children with KD by ELISA, and the data was analyzed using SPSS11.5 software. Thirty age matched children with infectious diseases（sepsis or pneumonia）, exclusive of heart, liver, kidney, blood diseases and autoimmune diseases such as rheumatoid were chosen in the fever control group. Re- suits Coronary artery lesions （CAL）were found in 17 children of KD group （17/47）by Doppler ultrasound examination. Significant differences （P 〈 0.05） of serum level of anti-β2GP1 antibody was showed between KD group （（7.46 ± 2.13） U/ ml）and the control group （（4.38 ± 0.43） U/ml） ; serum level of MMP-9 was （886.62 ± 92.72） ng/ml and （460.06 ± 179.59） ng/ml in KD group and the control group respectively, with significant difference between the two groups（P 〈 0.05）. In KD group, levels of anti-β2GPl were （8.83 ± 0.89） U/ml among children with CAL and （6.18 ± 1.42） U/ml among children without CAL, serum level of MMP-9 was （948.62 ± 81.76） ng/ml and （872.00 ± 34.74） ng/ml respectively, with significant differences （both P 〈 0.05 ）. In children with KD, the serum levels of anti-β2GPl antibody and MMP-9 were significantly correlated （correlation coefficient r = 0.665）. Condusions Serum levels of anti-β2 GP1 antibodies and MMP-9 increased in the acute phase of KD, and were significantly higher in those KD children with CAL. Anti-β2 GP1 antibodies and MMP-9 may play a role in the pathogenesis of KD, and can be used as an important serological indicator of KD with CAL.