川崎病患儿血清单核细胞趋化蛋白-1的变化及临床意义

目的观察川崎病(KD)患儿血清中单核细胞趋化蛋白-1(MCP-1)的浓度变化并探讨其临床意义。方法采用ELISA法检测66例KD患儿急性期和缓解期血清MCP-1浓度,另外选取健康儿童30例为对照组。心脏彩超观察KD患儿的冠状动脉损伤(CAL)情况。结果KD患儿急性期、缓解期和对照组的血清MCP-1水平分别为(488.2±159.5)pg/mL、(219.1±86.1)pg/mL、(101.1±28.2)pg/mL,急性期、缓解期均明显高于对照组(P<0.01),急性期高于缓解期(P<0.01);急性期出现CAL组(A组)、缓解期出现CAL组(R组)和无CAL组的血清MCP-1水平在急性期分别为(604.2±112.8)pg/mL、(614.1±115.7)pg/mL,(409.8±115.2)pg/mL,在缓解期分别为(280.1±97.3)pg/mL、(296.9±102.1)pg/mL、(196.1±88.8)pg/mL,无论在急性期和缓解期,A组和R组血清MCP-1浓度均高于无CAL组(P<0.05),但A组和R组比较差异无统计学意义(P=0.732)。结论KD患儿外周血MCP-1浓度可以反映KD的病情活动状态,持续高水平的MCP-1浓度有助于预测KD是否发生CAL。

Objective To observe the changes of serum concentration of monocyte chemotactic protein-1(MCP-1)in children with Kawasaki disease(KD)and to explore its clinical significance.Methods Serum MCP-1 concentrations in 66 KD children at acute stage and remission stage were determined by ELISA,and 30 healthy children were selected as control group.Coronary artery injury(CAL)was observed by color doppler echocardiography in KD children.Results The serum MCP-1 levels of KD children in acute stage,remission stage and healthy control group were(488.2±159.5)pg/mL,(219.1±86.1)pg/mL and(101.1±28.2)pg/mL,respectively.The serum MCP-1 levels in the acute stage and the remission stage were significantly higher than that in the control group(P<0.01),and that in the acute stage was significantly higher than that in the remission stage(P<0.01).Serum MCP-1 levels in the acute stage group(group A),the remission stage group(group R)and the non-CAL group,in the acute stage were(604.2±112.8)pg/mL,(614.1±115.7)pg/mL,(409.8±115.2)pg/mL,respectively.In the remission stages were(280.1±97.3)pg/mL,(296.9±102.1)pg/mL and(196.1±88.8)pg/mL,respectively.No matter in the acute stage and remission stage,serum concentration of MCP-1 in group A and group R were significantly higher than that in the no-CAL group(P<0.05).However,there was no significant difference between the group A and group R(P=0.732).Conclusion The concentration of MCP-1 in peripheral blood of children with KD can reflect the disease activity state of KD,and the continuous high level of MCP-1 concentration can help predict the occurrence of CAL in KD.