性激素对川崎病及冠脉损害的影响

Influence of sex hormone on Kawasaki disease and coronary artery damage

目的监测川崎病患儿外周血雌二醇(E_2)、睾酮(T)水平的变化,探讨其与川崎病发展及冠脉扩张程度变化的相关性。方法研究选取了2010年至2014年在西安市儿童医院心血管内科确诊的川崎病患儿60名为实验组,实验组又分为冠脉扩张组和无冠脉扩张组;对照组选取同期体检的60名健康儿童测微量元素余存血液进行对比。观察指标为E_2、T并与对照组进行比较。结果实验组E_2、T含量均低于对照组,差异存在统计学意义(t值分别为2.331、2.812,均P<0.05);无冠脉扩张组的E_2、T水平均高于冠脉扩张组,差异均具有统计学意义(t值分别为1.512和1.661,均P<0.05);实验组E_2在男、女性别之间相比,差异无统计学意义(t=0.543,P>0.05);实验组T在男、女性别之间相比,男性明显低于女性(t=1.533,P<0.05)。结论 E_2、T水平的变化对疾病确诊、发展和转归有较明确的意义,同时对预测川崎病冠脉损伤的发生有一定的预警作用。

Objective To monitor the changes of estradiol （ E2 ） and testosterone （T） levels in peripheral blood of Kawasaki disease （ KD ） and explore their correlation with the pathogenesis of KD and changes of coronary artery dilation. Methods In cardiovascular department of Xi＇ an Children＇ s Hospital 60 children diagnosed with KD were selected for experimental group from 2010 to 2014, and they were divided into coronary artery dilation group and no coronary artery dilation group. Sixty healthy children were selected in control group and the residual blood after examining trace elements were used for comparison. The observation indexes included E2 and T, and results were compared with the control group. Results The levels of E2 and T in the experimental group were lower than those in the control group, and the differences were significant （t value was 2. 331 and 2. 812, respectively, both P 〈0.05）. Those in no coronary artery dilation group were higher than coronary artery dilation group with significant difference （t value was 1.512 and 1. 661, respectively, both P 〈 0.05 ）. In the experimental group E2 level was not remarkably different between males and females （ t = 0. 543, P 〉 0.05 ） , while T level was obviously higher in females than in males （t = 1. 533 ,P 〈 0.05 ）. Conclusion The changes of E2 and T levels are important for diagnosis, development and outcomes of disease, and they can be used to predict the occurrence of coronary artery damage in KD.