生长分化因子-15水平变化与川崎病发病过程的相关性研究

A study about the interrelation between the changes of GDF-15 and the development of Kawasaki disease

目的通过对血浆生长分化因子-15(GDF-15)水平检测,研究其在川崎病(KD)发病过程中的作用,并对其与冠状动脉扩张的相关性进行分析。方法采用酶联免疫法,检测确诊为川崎病的50例患儿在急性期、亚急性期GDF-15水平,并同时统计其红细胞沉降率(ESR)及CRP值的变化,然后与正常对照组的20例健康儿童进行比较。通过超声心动图检测冠状动脉扩张程度,比较冠状动脉扩张组与不伴冠状动脉扩张组GDF-15、ESR、CRP水平,并对急性期、亚急性期血浆GDF-15水平与ESR、CRP及冠状动脉扩张程度进行相关性分析。结果川崎病患儿血浆GDF-15、ESR、CRP水平急性期[(1 755.04±165.88)ng/ml、(70.54±9.63)mm/1 h、(75.19±20.22)mg/L]高于亚急性期[(1 098.87±70.85)ng/ml、(10.56±1.37)mm/1 h、(12.77±6.57)mg/L],亚急性期高于正常对照组[(477.55±31.14)ng/ml、(5.65±1.73)mm/1 h、(5.40±1.82)mg/L],差异有统计学意义(P<0.05);伴有冠状动脉扩张组明显高于不伴冠状动脉扩张组,差异有统计学意义(t=8.62,P<0.05;t=4.60,P<0.05;t=5.18,P<0.05);川崎病急性期GDF-15水平与ESR、CRP及冠状动脉扩张程度存在正相关(r=0.58,P<0.05;r=0.41,P<0.05;r=0.56,P<0.05)。结论 GDF-15在川崎病的发病过程中存在一定的作用,同时在川崎病并发冠状动脉损伤过程中发挥着重要作用。

Objective By detecting the level of plasma(growth differentiation factor 15,GDF-15) to explore its role in the pathogenesis of Kawasaki disease(KD) and to investigate the relationship between GDF-15 and coronary artery dilatation. Methods By enzyme-linked immunosorbent assay to detect GDF-15 levels in acute and subacute stage of 50 children with Kawasaki disease, and compared with normal control group of 20 healthy children. By echocardiography to detect the extent of coronary artery dilatation, compare the levels of CRP, ESR and GDF-15 in the coronary artery dilation group and the non associated coronary artery and analyze the correlation of the plasma GDF-15 with ESR, CRP and coronary artery dilation in acute stage. Result The levels of CRP, ESR and GDF-15 in acute KD patients [(1 755.04±165.88)ng/ml,(70.54±9.63)mm/1 h,(75.19±20.22)mg/L] were higher than those in subacute stage [(1 098.87±70.85)ng/ml,(10.56±1.37)mm/1 h,(12.77±6.57)mg/L], subacute stage was higher than that of normal control group [(477.55±31.14)ng/ml,(5.65±1.73)mm/1 h,(5.40±1.82)mg/L](P<0.05). The level of GDF-15 in acute Kawasaki disease patients with coronary artery dilatation was higher than that in Kawasaki disease patients with non-coronary artery dilatation(t=8.62, P<0.05; t=4.60, P<0.05; t=5.18, P<0.05). In addition, the level of GDF-15 in acute Kawasaki disease patients showed positive correlation with ESR, CRP and the degree of coronary artery dilation(r=0.58, P<0.05; r=0.41, P<0.05; r=0.56, P<0.05). Conclusions GDF-15 may be associated with the pathogenesis of Kawasaki disease, and play an important role in the process of coronary artery injury in Kawasaki disease.