CRP、TNF-α及IgG在川崎病患儿中的变化及其意义

Changes of CRP, TNF-α and IgG in children with Kawasaki's disease and their significance

目的观察C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)及免疫球蛋白G(Ig G)在川崎病患儿中的变化并探讨其临床意义。方法选择2011年3月至2016年2月在海南省人民医院、海口市人民医院及我院治疗的68例川崎病患儿进行研究,于急诊期和恢复期测定其CRP、TNF-α及Ig G水平,就所有患儿在上述两个阶段的CRP、TNF-α及Ig G水平进行比较。于急诊期对所有患儿进行心动图检测,按是否伴有冠脉病变分为冠脉病变组19例和非冠脉病变组49例,对比两组患儿在急诊期的CRP、TNF-α及Ig G水平。结果 68例川崎病患儿在急诊期的CRP、TNF-α及Ig G水平分别为(26.88±8.31)mg/L、(21.54±6.19)ng/L及(19.88±7.16)g/L,明显高于正常水平;经治疗,患儿的各项指标水平显著下降,患儿在恢复期的各指标水平分别为(8.15±2.94)mg/L、(13.41±5.02)ng/L、(12.51±4.13)g/L,明显低于急诊期,差异均有统计学意义(P<0.05);伴有冠脉损伤的患儿,其CRP、TNF-α及Ig G水平分别为(28.19±8.44)mg/L、(26.26±5.75)ng/L及(19.28±7.15)g/L,均明显高于未伴有冠脉损伤的患儿的(17.28±5.36)mg/L、(18.21±4.58)ng/L及(13.75±5.28)g/L,组间比较差异均有统计学意义(P<0.05)。结论 CRP、TNF-α及Ig G水平的变化与川崎病患儿的急性炎症反应程度及病情发展有关,因此可将其作为预测患儿是否伴有冠状动脉病变的重要参考指标。

Objective To research changes of C reactive protein（CRP）, tumor necrosis factor-α（TNF-α） and immunoglobulin G（Ig G） in children with Kawasaki＇s disease（KD） and their significance. Methods A total of 68 children with KD in People＇s Hospital of Hainan Province, Haikou People＇s Hospital and Hainan Obstetrics and Gynecology Hospital from March 2011 to February 2016 were selected as research objects. The levels of CRP, TNF-α and Ig G were determined and compared in emergency and recovery periods. In the emergency period, all children were performed echocardiography. The children were divided into coronary lesion group（n=19） and non-coronary lesion group（n=49） according to whether or not associated with coronary artery disease. The levels of CRP, TNF-α and Ig G between the two groups were compared in emergency period. Results The levels of CRP, TNF-α and Ig G in emergency period were respectively（26.88±8.31） mg/L,（21.54±6.19） ng/L and（19.88±7.16） g/L, which were significantly higher than the normal levels.After treatment, the levels were significantly decreased to（8.15±2.94） mg/L,（13.41±5.02） ng/L and（12.51±4.13） g/L respectively in the recovery period, which were significantly lower than those in the emergency period（P〈0.05）. The levels of CRP, TNF-α and Ig G in coronary lesion group were respectively（28.19 ± 8.44） mg/L,（26.26 ± 5.75） ng/L and（19.28±7.15） g/L, which were significantly higher than（17.28±5.36） mg/L,（18.21±4.58） ng/L and（13.75±5.28） g/L in non-coronary lesion group（P〈0.05）. Conclusion The changes of CRP, TNF-α and Ig G levels are closely related to the severity of acute inflammation and the development of the disease in children with Kawasaki＇s disease. Therefore,they can be used as important reference indexes to predict coronary artery disease.