联合检测外周血辅助性T细胞9与白细胞介素-9对急性期川崎病患儿的临床诊治价值

Diagnostic value of combined detection of T helper 9 cells and interleukin-9 in children at acute stage of Kawasaki disease

目的研究辅助性T细胞9(T helper 9,Th9)与白细胞介素-9(interleukin-9,IL-9)在急性期川崎病(Ka-wasaki disease,KD)患儿外周血的表达情况,并与KD患者的临床指标进行相关性分析,评价其对KD诊断的临床意义。方法选取2015年1月至2016年12月在徐州市儿童医院被确诊为急性期KD患儿42例作为KD组,同期选择健康体检儿童42名作为健康对照组,并对KD组患者进行恢复期随访。采用流式细胞术检测两组儿童外周血中的Th9细胞的变化;酶联免疫吸附试验(ELISA)检测两组儿童血清中IL-9的表达浓度;比较Th9和IL-9与KD患者各临床指标的相关性。结果 KD组患儿外周血中Th9细胞比例明显高于健康对照组,差异具有统计学意义(P<0.05);KD患儿急性期外周血中Th9细胞比例明显高于恢复期,差异具有统计学意义(P<0.05)。KD组患儿外周血中IL-9表达浓度明显高于健康对照组,差异具有统计学意义(P<0.05);KD组患儿急性期外周血中IL-9表达浓度明显高于恢复期,差异具有统计学意义(P<0.05)。KD患儿急性期外周血中Th9细胞比例与降钙素原(PCT)、C反应蛋白(CRP)、红细胞沉降率(ESR)、丙氨酸氨基转移酶(ALT)、白细胞计数(WBC)及球蛋白(GLB)浓度呈正相关(r=0.406、0.315、0.379、0.305、0.382、0.375,均P<0.05);与血清白蛋白(ALB)浓度呈负相关(r=-0.318,P<0.05);血清中IL-9表达浓度与降钙素原、C反应蛋白、红细胞沉降率、丙氨酸氨基转移酶、白细胞计数及球蛋白浓度呈正相关(r=0.447、0.368、0.402、0.376、0.329、0.462,均P<0.05);与血清白蛋白浓度呈负相关(r=-0.343,P<0.05)。结论 KD患儿急性期外周血中Th9细胞比例及IL-9表达浓度明显升高,且与疾病活动度及相关临床指标关系密切,提示Th9及IL-9参与KD患儿的发病及病情发展。

Objectives To investigate the expressions of peripheral blood T helper9(Th9)cells and interleukin-9(IL-9)in children at acute stage of Kawasaki disease(KD),and analyze the association of Th9and IL-9with the clinical index of KD children as well as evaluate the clinical significance of KD by Th9and IL-9.Methods A total of42children at acute stage of KD diagnosed from January2015to December2016in Xuzhou Children′s Hospital were enrolled as KD group,and the children were followed up in the recovery stage.Another42healthy children underwent physical examination were enrolled as healthy control group.Flow cytometry was used to measure the percentage of peripheral blood Th9cells,and enzyme linked immunosorbent assay(ELISA)was used to measure serum concentrarion of IL-9.Results Percentage of peripheral blood Th9cells in KD group was significantly higher than that in healthy control group(P<0.05);Children at acute stage of KD showed a significantly higher percentage of Th9cells compared with that in recovery stage(P<0.05).Concentration of IL-9in KD group was significantly higher than that in healthy control group(P<0.05);Children at acute stage of KD showed a significantly higher concentration of IL-9compared with that in recovery stage(P<0.05).Percentage of Th9cells was positively correlated with procalcitonin(PCT),C reactive protein(CRP),erythrocyte sedimentation rate(ESR),alanine aminotransferase(ALT),white blood cell count(WBC)and globulin(GLB)(r=0.406,0.315,0.379,0.305,0.382and0.375respectively,all P<0.05),but was negatively correlated with serum albumin(ALB)(r=-0.318,P<0.05)in KD children at acute stage.Concentration of IL-9was positively correlated with PCT,CRP,ESR,ALT,WBC,GLB(r=0.447,0.368,0.402,0.376,0.329and0.462respectively,all P<0.05),but was negatively correlated with ALB(r=-0.343,P<0.05)in KD children at acute stage.Conclusions Children at acute stage of KD show significant increasing of percentage of peripheral Th9cells and concentration of IL-9,which are closely correlated with disease activity and related clinical indexes.These results indicate that Th9cells and IL-9may play an important role in the occurrence and pathogenesis of KD.