丙种球蛋白对川崎病患儿血清明胶酶检测量影响的临床研究

The clinical study of serum gelatinase in Kawasaki disease by gamma globulin treatment

目的冠状动脉探讨丙种球蛋白对川崎病患儿血清基质金属蛋白酶（MMP）-2及MMP-9检测的影响和临床意义，以积累经验，指导临床工作。方法选取61例川崎病患儿，随机分为两组：对照组（16例）应用常规治疗；观察组（45例）在常规治疗的基础上加用丙种球蛋白，观察组患儿按有无冠状动脉损伤分为两组：冠状动脉损伤组（28例）和无冠状动脉损伤组（17例）。检测治疗前和治疗后患儿血清MMP-2和MMP-9的变化。结果对照组MMP-2和MMP-9治疗前后比较，差异均无统计学意义（P〉0．05）。观察组治疗前MMP-2和MMP．9[（266．4±88．0）、（443．5±113．4）μg／L]与治疗后[（181．8±46．4）、（254．9±113．4）μg／L]比较，差异均有统计学意义（P〈0．05），观察组治疗后MMP．2和MMP一9与对照组治疗后比较，差异均有统计学意义（P〈0．05）。冠状动脉损伤组MMP-2、MMP．9减少值明显高于无冠状动脉损伤组，两组比较差异均有统计学意义（P〈0．05）。结论丙种球蛋白能显著降低川崎病患儿血清MMP-2和MMP-9的表达，对减缓冠状细胞外基质的损伤有重要作用。

Objective To observe the expressions of matrix metalloproteinase （MMP）-2 and MMP-9, explore their clinical significance in patients with Kawasaki disease by gamma globulin treatment, for accumulating clinical experience and directing the clinical work. Methods Sixty-one patients with Kawasaki disease were divided into two groups, the observation group （45 cases） were treated by gamma globulin, the control group （16 cases） were treated by routine treatment. The observation group was divided into the cardiovascular damage group （28 cases） and the non-cardiovascular damage group （17 cases）. MMP-2 and MMP-9 were detected in the pre-treatment and post-treatment. Results There were no significant difference in the expressions of MMP-2 and MMP-9 between the pre-treatment and post-treatment in the control group （P 〉0.05）. The expressions of MMP-2 and MMP-9 were obviously lower in the post-treatment [ （ 181.8 ± 46.4）, （254.9 ± 113.4）μg/L ] than those in the pre-treatment [ （266.4 ± 88.0）, （443.5 ±113.4）μg/L ] in the observation group （P 〈0.05）. There were significant difference in the expressions of MMP-2 and MMP-9 in the post-treatment between the observation group and the control group （P 〈 0.05 ）. The decrease value of MMP-2 and MMP-9 were higher in the cardiovascular damage group than those in the non-cardiovascular damage group （P 〈 0.05 ）. Conclusions The treatment of gamma globulin can decrease the expressions of MMP-2 and MMP-9 in Kawasaki disease. The gamma globulin may be value to reduce the extracellular matrix injury of Kawasaki disease.