急性期和亚急性期川崎病患儿血清TIMP1、GAL-3、GDF-15水平变化及临床意义

Changes of serum TIMP1,GAL-3 and GDF-15 levels in children with acute and subacute Kawasaki disease and theiRclinical significances

目的探讨急性期和亚急性期川崎病患儿血清基质金属蛋白酶抑制剂1(TIMP1)、血浆半乳糖凝集素-3(GAL-3)、生长分化因子(GDF-15)水平变化情况及其临床意义。方法随机选取2019年10月至2021年5月收治的川崎病患儿100例,其中急性期患儿65例,亚急性期患儿35例,比较2组川崎病患儿血清TIMP1、GAL-3、GDF-15水平,并对2组患儿免疫功能指标、炎性因子水平指标和心功能水平指标进行比较。结果急性期川崎病患儿血清TIMP1、GAL-3、GDF-15水平高于亚急性期患儿,差异有统计学意义(t=11.873、9.729、11.230,P<0.05)。急性期川崎病患儿CD3+、CD4+和CD4+/CD8+高于亚急性期患儿,CD8+水平低于亚急性期患儿,差异有统计学意义(t=15.938、4.612、13.326、10.731,P<0.05)。急性期川崎病患儿CRP、IL-6和TNF-α水平高于亚急性期患儿,差异有统计学意义(t=18.443、26.424、7.488,P<0.05)。急性期和亚急性期川崎病患儿LVSF、LVEF、CI和E/A等心功能水平指标差异无统计学意义(t=0.173、0.976、2.477、0.265,P>0.05)。结论川崎病患儿在急性期血清TIMP1、GAL-3、GDF-15水平明显升高,可考虑作为判断患儿所处时期的实验室指标,且急性期免疫功能指标、炎性因子水平指标也与亚急性期患儿存在差异,可考虑作为辅助判断指标。

Objective To investigate the changes of serum tissue inhibitoRof metalloproteinase-1(TIMP1),Galectin-3(Gel-3)and growth differentiation factoR15(GDF-15)levels in children with acute and subacute Kawasaki disease and theiRclinical significances.Methods A total of 100 children with Kawasaki disease admitted to ouRhospital from OctobeR2019 to May 2021 were randomly selected,including 65 in acute stage and 35 in subacute stage.Serum levels of TIMP1,GAL-3 and GDF-15,immune function indexes,inflammatory factoRlevel and cardiac function indexes in children with acute and subacute Kawasaki disease were compared.Results Serum levels of TIMP1,GAL-3 and GDF-15 in children with acute Kawasaki disease were significantly higheRthan those in subacute stage(t=11.873,9.729 and 11.230,respectively;P<0.05).The levels of CD3+,CD4+and CD4+/CD8+in children with acute Kawasaki disease were significantly higheRthan those in subacute stage,but CD8+level was significantly loweR(t=15.938,4.612,13.326 and 10.731,respectively;P<0.05).The levels of C-reactive protein(CRP),interleukin-6(IL-6)and tumoRnecrosis factor-α(TNF-α)in children with acute Kawasaki disease were significantly higheRthan those in subacute stage(t=18.443,26.424 and 7.488,respectively;P<0.05).There were no significant differences in the left ventriculaRsystolic function(LVSF),left ventriculaRejection fraction(LVEF),cardiac index(CI)and early to late diastolic transmitral flow velocity(E/A)ratio between children with acute and subacute Kawasaki disease(t=0.173,0.976,2.477 and 0.265,respectively;P>0.05).Conclusion Serum levels of TIMP1,GAL-3 and GDF-15 significantly increase in children with acute Kawasaki disease,which can be considered as laboratory indicators to determine the clinical stage of Kawasaki disease.In addition,immune function indexes and inflammatory factors in children with acute Kawasaki disease also diffeRfrom those in the subacute stage,which can be considered as auxiliary indicators to determine the clinical stage of Kawasaki disease.