川崎病血清HSP27和HSP70水平与冠状动脉病变关系的研究

Correlations of serum heat shock protein 27 and heat shock protein 70 levels with coronary artery lesions in children with Kawasaki disease

目的探讨川崎病(KD)病理进程中患儿血清热休克蛋白27(HSP27)和热休克蛋白70(HSP70)的表达水平,分析其与KD病理机制及冠状动脉病变的关系。方法收集2017年1月至2019年12月陕西省人民医院儿童病院收治的住院KD患儿30例为KD组,另选取同期体检健康儿童为对照组(30例)。根据是否合并冠状动脉损伤,将KD组患儿分为KD冠状动脉损伤(KD-CAL)组(12例)与KD非冠状动脉损伤(KD-NCAL)组(18例);根据KD病理变化,将KD组患儿分为病程在1~9天时的KD急性期组与病程在10~31天时的KD缓和期组。应用酶联免疫吸附法(ELISA)检测各组儿童血清中HSP27和HSP70水平,并进行统计分析。结果 KD急性期组、KD缓和期组及对照组的血清HSP27和HSP70水平比较差异均有统计学意义(F值分别为5.47、7.65,P<0.05);KD急性期组分别与KD缓和期组及对照组的血清HSP27和HSP70水平比较差异均有统计学意义(t值分别为15.23、14.32、16.72、13.75,P<0.05);KD缓和期组与对照组的血清HSP27和HSP70水平比较差异均有统计学意义(t值分别为12.36、13.75,P<0.05)。KD-CAL组急性期与KD-NCAL组急性期的血清HSP27和HSP70水平比较差异均有统计学意义(t值分别为13.34、14.65,P<0.05);KD-CAL组缓和期与KD-NCAL组缓和期的血清HSP27和HSP70水平比较差异均有统计学意义(t值分别为12.53、13.72,P<0.05)。结论 KD急性期患儿血清中HSP27和HSP70水平显著增高,其均在KD急性期抑制了血管炎性反应;KD缓和期患儿血清HSP27和HSP70水平持续较高,其对血管炎性反应的抑制作用可以维持至病程的缓和期。KD-NCAL组患儿血清HSP27和HSP70水平较KD-CAL组明显升高,其在KD冠状动脉病变中可能起保护作用。

Objective To detect expression levels of serum heat shock protein 27(HSP27) and heat shock protein 70(HSP70) in pathological process of Kawasaki disease(KD),and analyze their correlations with the pathogenisis of KD and coronary artery lesions.Methods 30 children with KD who admitted to Department of Pediatrics of Shaanxi Provincial People′s Hospital over a period from January, 2017 to December, 2019 were selected and enrolled in KD group.Other 30 healthy children who received physical examination in the same period were as the controls.According to whether they had coronary artery lesion, 30 children with KD were divided into coronary artery lesion group(KD-CAL group)(12 cases) and non-coronary artery lesion group(KD-NCAL group)(18 cases).Again, according to course of the disease, these children with 1-9 days of KD course werew divided into acute stage KD subgroup and those children with 10-31 days of KD course were divided into alleviated stage KD subgroup.The expression levels of HSP27 and HSP70 in the serum of the children in each group were detected by enzyme-linked immunosorbent assay(ELISA).The results were analyzed statistically.Results The serum HSP27 and HSP70 levels of the children in the acute stage KD subgroup, the alleviated stage KD subgroup and the control group were significantly different(F=5.47 and 7.65 respectively, both P<0.05).There were statistically significant differences in serum HSP27 and HSP70 levels of the children between the acute stage KD subgroup and the alleviated stage KD subgroup, and between the acute stage KD subgroup and the control group(t=15.23,14.32,16.72 and 13.75 respectively, all P<0.05).Also, there were statistically significant differences in serum HSP27 and HSP70 levels between the alleviated stage KD subgroup and the control group(t=12.36 and 13.75 respectively, both P<0.05).There were significant differences in serum HSP27 and HSP70 levels of the children between the acute stage KD-CAL group and the acute stage KD-NCAL group(t=13.34 and 14.65 respectively, both P<0.05).So did between the alleviated stage KD-CAL group and the alleviated stage KD-NCAL group(t=12.53 and 13.72 respectively, both P<0.05).Conclusion The expression levels of HSP27 and HSP70 in serum of the children with KD in the acute stage increase significantly, and they both play some roles in inhibiting vascular inflammatory response in acute stage of the disease.And in the alleviated(remission) stage, they still remain at high levels, suggesting that their inhibitory roles on vasoinflammatory response could last till to the remission stage of the disease.Moreover, the serum HSP27 and HSP70 levels of the children in the KD-NCAL group are significantly higher than those in the KD-CAL group, suggesting that they may play protective roles in KD coronary artery lesions.