内源性血管弹性蛋白酶检测对川崎病患儿冠状动脉损伤的评估价值

Evaluation of endogenous vascular elastase detection to coronary artery lesion in Kawasaki disease

目的 评估川崎病患儿血清中内源性血管弹性蛋白酶（EVE）含量检测对该病冠状动脉损伤情况的诊断价值。方法选择2012年1月~2013年4月诊断明确的川崎病患儿共60例作为病例组，抽取其发病0~11d（病理Ⅰ期）、12~25d（病理Ⅱ期）时外周静脉血；将60例同期因发热就诊的非川崎病患儿作为对照组，于发热急性期抽取外周静脉血。采用酶联免疫法（ELISA）检测两组血清中EVE含量，病例组分别于发病7d和14d行超声心动图检查冠状动脉损伤情况，分析患儿血清EVE含量与其冠状动脉损伤的相关性。结果病例组Ⅰ期和Ⅱ期时的血清EVE含量均高于对照组，差异有显著性（P〈0.05），超声心动图显示Ⅰ期时有冠状动脉损伤者3例，Ⅱ期时有冠状动脉损伤者17例，病例组中有冠状动脉损伤患儿血清中EVE含量均明显高于无冠状动脉损伤的患儿，差异有统计学意义（P〈0.05）。结论 EVE含量测定可能对川崎病患儿冠状动脉损伤情况的评估具有重要的临床价值。

Objective To assess the value of EVE detection to coronary artery lesion in KD. Methods A total of 120 pediatric patients were enrolled in the study and assigned to KD group （n=60） and control group （Non-KD with fever, n=58）. Patients in the KD group was arranged to collect 2ml venous blood respectively in pathology phase Ⅰ（0~11d） andII（12~25d）. Children in the control group were exsanguinated when had a fever. Blood samples of endogenous vascular elastase （EVE） was detected by enzyme linked immunoserbent assay （ELISA）. UCG was used to detect the coronary artery in the seventh and four-teenth days respectively. The relationship of serum EVE level and coronary artery lesion （CAL） were analysed. Results The level of EVE in the I phase and II phase were higher than that of the control group （P〈0.05）. There were 3 cases in the Ⅰphase with CAL, and 17 cases in the II phase with CAL. The serum EVE level of children with CAL were higher than those who without CAL in KD group. The difference was statistically significant （P〈0.05）. Conclusion The content detection of EVE may have important clinical value in the assessment of CAL in KD.