川崎病患儿血浆MMP-9、NT-proBNP水平变化及其临床意义

Changes of Plasma MMP-9,NT-proBNP Levels in Children with Kawasaki Disease and Its Clinic Significance

目的:探讨基质金属蛋白酶-9(MMP-9)与N末端脑利钠肽(NT-pro BNP)在川崎病(KD)患儿血浆中的变化及其意义。方法:选取2015年1月-2016年1月本院明确诊断的KD患儿42例为研究对象,根据心脏彩超分为冠状动脉损伤(CAL)组18例、无冠状动脉损伤(NCAL)组24例,另选取同期伴有发热的呼吸道感染患儿30例和门诊健康体检儿童20例作为对照组,分别测定各组MMP-9、NT-pro BNP蛋白水平。结果:KD患儿急性期血浆MMP-9、NT-pro BNP水平均高于对照组(P<0.01),并且CAL组较NCAL组升高更显著,差异均有统计学意义(P<0.05)。KD患儿缓解期血浆MMP-9及NT-pro BNP水平均较急性期显著降低(P<0.01),CAL组较NCAL组血浆NT-pro BNP水平仍高,比较差异均有统计学意义(P<0.05)。MMP-9与NT-pro BNP水平成正相关关系(r=0.57,P<0.05)。结论:血浆MMP-9和NT-pro BNP与KD患儿心血管损害关系密切,联合检测有助于早期诊断KD和预测CAL发生。

Objective:To explore the changes and clinic significance of plasma matrix metalloproteinase-9(MMP-9) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in children with Kawasaki disease(KD).Method:Forty two children with KD in our hospital from January 2015 to January 2016 were collected and divided into two groups according to the results of echocardiography,the coronary artery lesion(CAL) group(n=18) and the non-coronary artery lesion(NCAL) group (n=24).Thirty febrile children with respiratory tract infection and twenty healthy children in the same period were chosen as the control group.The plasma MMP-9 and NT-proBNP protein levels were measured respectively.Result:The plasma MMP-9 and NT-proBNP levels in the acute phase of KD patients were all higher than those in the two control group(P<0.01),and which were significantly higher in the CAL group than in the NCAL group,the differences were statistically significant(P<0.05 ).The plasma MMP-9 and NT-proBNP levels in remission stages were siginificantly lower after treatment,and the protein level of NT-proBNP in the CAL group was still higher than that of the NCAL group,the differences were statistically significant(P<0.05).There was a positive correlation between plasma MMP-9 and NT-proBNP levels in the acute phase of KD(r=0.57,P<0.05).Conclusion:The plasma MMP-9 and NT-proBNP levels are closely related to KD cardiovascular damage,combined detection of them may have critical value for the early diagnosis of KD and the prediction of CAL.