川崎病患者治疗前后血清淀粉样蛋白和炎症因子变化及其相关性分析

Changes of serum amyloid and inflammatory factors in patients with Kawasaki disease before and after treatment and their correlation analysis

目的 :探究川崎病(KD)患儿治疗前后血清淀粉样蛋白(SAA)和炎症因子的变化及其之间的相关关系。方法 :选取2012～2017年我院确诊的KD患儿84例作为研究对象,根据彩超检查结果分为冠脉损伤组40例(CAL组),无冠脉损伤组44例(NCAL组),纳入同期健康儿童50例作为健康对照组,各组儿童治疗前后分别抽取静脉血检测SAA和白细胞介素6(IL-6)、白细胞介素8(IL-8)及肿瘤坏死因子-а(TNF-а)的含量,分析各项指标在疾病病程中的变化及其相关关系。结果 :三组患儿SAA水平在治疗前及治疗后比较均有显著差异;CAL组和NCAL组的治疗前后SAA水平比较均有显著差异;CAL组SAA水平高于NCAL组,两组比较有统计学差异;健康组治疗前后SAA水平比较不具有统计学差异。三组患儿IL-6、IL-8及TNF-а水平在治疗前及治疗后比较均有显著差异;CAL组和NCAL组的治疗前后IL-6和TNF-а水平比较均有显著差异;NCAL组IL-8水平在治疗前后比较不具有统计学差异;健康组治疗前后IL-6、IL-8及TNF-а水平比较不具有统计学差异。KD患儿SAA水平与IL-6和TNF-а水平均呈高度正相关;KD患儿SAA水平与IL-8水平不相关;KD患儿IL-6水平与TNF-а水平呈中度正相关;KD患儿IL-8水平与IL-6水平和TNF-а水平均不相关。结论 :SAA、IL-6和TNF-а参与了KD的发病过程,其水平的改变与KD患儿出现血管炎性反应、CAL有关。

Objective To investigate the changes of serum amyloid protein(SAA)and inflammatory factors in children with Kawasaki disease(KD)before and after treatment.Methods A total of 84 children with KD diagnosed in our hospital from 2012 to 2017 were enrolled.According to the results of color Doppler ultrasonography,40 patients in the coronary artery injury group(CAL group)and 44 patients without coronary artery injury(NCAL group)were included in the same period.50 healthy children were used as healthy control group.The venous blood was taken before and after treatment in each group to detect SAA and interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-а).The content of the indicators,analysis of the changes in the disease course and its related relationship.Results The levels of SAA in the three groups were significantly different before and after treatment.There were significant differences in SAA levels between the CAL group and the NCAL group before and after treatment.The SAA level in the CAL group was high.In the NCAL group,there was a statistically significant difference between the two groups.There was no significant difference in SAA levels between the two groups before and after treatment.The levels of IL-6,IL-8 and TNF-αin the three groups were significantly different before and after treatment.The levels of IL-6 and TNF-αbefore and after treatment in the CAL group and the NCAL group were compared.There were significant differences.The levels of IL-8 in NCAL group were not statistically different before and after treatment.The levels of IL-6,IL-8 and TNF-αin the healthy group were not compared before and after treatment.Statistical difference.The level of SAA in children with KD was highly positively correlated with IL-6 and TNF-аlevels.The level of SAA in children with KD was not correlated with IL-8 level;IL-6 levels in children with KD were positively correlated with TNF-αlevels;IL-8 levels and IL-6 levels in children with KD The TNF-аlevel was not correlated.Conclusion SAA,IL-6 and TNF-αare involved in the pathogenesis of KD,and the level changes with KD children.There is a vasculitic reaction and CAL.