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

Significance of changes of tumor necrosis factor-α expression in children with Kawasaki disease before and after treatment

目的探讨川崎病患儿治疗前后血清肿瘤坏死因子-α(TNF-α)的变化及其在KD发病中的意义。方法选择2005年1月至2009年12月我院儿科收治的KD患儿76例,按超声心动图检查结果将76例KD患儿分为CAL组(30例)和无CAL组(46例)。同时,随机选择同期在我院门诊体检的健康儿童30例为对照组。采取双抗体夹心酶免疫吸附试验(ELISA)法分别测定76例KD患儿治疗前、后和对照组儿童门诊体检时的TNF-α水平。结果治疗前CAL组和无CAL组TNF-α水平均明显高于对照组,差异有统计学意义(P<0.05);且CAL组TNF-α水平明显高于无CAL组,差异有统计学意义(P<0.05)。治疗后CAL组和无CAL组TNF-α水平均明显降低,差异有统计学意义(P<0.05);无CAL组和对照组TNF-α水平基本一致。结论 TNF-α作为一种主要促炎细胞因子,参与了KD炎症/免疫反应发生发展过程,并与CAL呈正相关,在KD致CAL的预测和预后评估中具有重要的临床价值。

Objective To investigate the significance of changes of tumor necrosis factor-α（TNF-α） expres-sion in children with Kawasaki disease（KD） before and after treatment.Methods 76 patients with KD were admitted from January 2005 to December 2009,according to results of echocardiography,and divided into the CAL group（30 cases） and non-CAL group（46 cases）.At the same time,30 cases of physical examination of healthy children were randomly selected over the same period in our clinic as control group.Double antibody sandwich enzyme immunosor-bent assay（ELISA） were employed to measure TNF-α levels in patients with KD patients before and after treatment and control groups.Results Before treatment,the level of TNF-α in non-CAL and CAL group were significantly higher than that in control group（P0.05）;and the level of TNF-α in CAL group were significantly higher than that in non-CAL（P0.05）.After treatment,the level of TNF-α in non-CAL and CAL group were significantly lower（P 0.05）;non-CAL group and the control group had similar the level of TNF-α.Conclusion TNF-α involved in KD inflammatory / immune reaction in the development process,and was positively correlated with CAL,and there is im-portant clinical value in the prediction to prognosis of KD induced by CAL.