川崎病患儿外周血AngⅡ和ox-LDL的表达及意义

The expression and clinical significance of AngⅡ and ox-LDL in peripheral blood of children with Kawasaki disease

目的探讨川崎病(KD)患儿外周血血管紧张素Ⅱ(AngⅡ)及氧化低密度脂蛋白(ox-LDL)的表达和临床意义。方法选择2014年11月至2017年11月收治的KD患儿86例为观察组,选择同期86例健康体检儿童为对照组。观察组患儿给予丙种球蛋白和阿司匹林等治疗6个月,治疗过程中采用酶联免疫吸附法(ELISA)检测观察组疾病各期与对照组外周血中AngⅡ和ox-LDL的浓度。比较2组患儿外周血中AngⅡ和ox-LDL的表达差异性,分析AngⅡ和ox-LDL与患儿体内炎性因子的相关性,同时对观察组患儿采用超声心动图检测患儿冠状动脉损伤情况,分析AngⅡ和ox-LDL与冠状动脉损伤的相关性。结果随着疾病的恢复,患儿外周血中AngⅡ和ox-LDL含量逐渐降低,差异有统计学意义(P<0.05),观察组患儿急性期和亚急性期外周血中AngⅡ和ox-LDL含量明显高于对照组(P<0.05);外周血AngⅡ和ox-LDL含量与CRP、PCT、ESR、PLT、球蛋白成正相关,与白蛋白呈负相关(P<0.05);CAL组的外周血AngⅡ和ox-LDL含量明显高于NCAL组(P<0.05)。结论外周血AngⅡ和ox-LDL水平与KD发生、发展、转归密切相关,且可能参与疾病所并发症的冠脉损伤,有利于指导临床。

Objective To investigate the expression and clinical significance of angiotensin Ⅱ(Ang Ⅱ) and oxidized low density lipoprotein(ox-LDL) in peripheral blood of children with Kawasaki disease(KD).Methods A total of 86 children patients with Kawasaki disease who were admitted and treated in our hospital from November 2014 to November 2017 were enrolled as observation group,and the other 86 healthy children who received physical examination at the same period were enrolled as control group.The patients in observation group were treated by gamma globulin and aspirin for 6 months.The levels of AngⅡ and ox-LDL in peripheral blood were detected by enzyme-linked immunosorbent assay(ELISA),and the correlation between the expression of Ang Ⅱ,ox-LDL in peripheral blood and inflammatory factors was analyzed. Moreover the difference of expression of Ang Ⅱ and ox-LDL in peripheral blood was compared. In addition the coronary artery injury condition of patients in observation group was examined by echocardiography, and the correlation between the expression of Ang Ⅱ,ox-LDL and coronary artery injury was analyzed.Results With the recovery of the disease,the levels of AngⅡ and ox-LDL in peripheral blood of patients were gradually decreased,and the difference was statistically significant(P<0.05).The levels of AngⅡ and ox-LDL in peripheral blood at phase and subacute phase in observation group were significantly higher thanthose in control group(P<0.05). Moreover the levels of AngⅡ and ox-LDL in peripheral blood were positively correlated with those of CRP,PCT,ESR,PLT,globulin,however,which were negatively correlated with those of albumin(P<0.05).In addition the levels of AngⅡ and ox-LDL in CAL group were significantly higher than those in NCAL group(P<0.05).Conclusion The levels of Ang Ⅱ and ox-LDL in peripheral blood are closely related to the pathogenesis,development and prognosis of KD,which may be involved in the incidence of coronary artery injury.