川崎病免疫发病机制及静注丙种球蛋白疗效研究  

Study of cellular immune function and mechanisms of intravenous gammaglobulin in Kawasaki disease.

作　　者：郑淑梅[1] 刘文彬[1] 王云侠[1] 张宏伟[1] 

机构地区：[1]成都军区总医院,四川成都610083

出　　处：《四川医学》2004年第8期879-880,共2页Sichuan Medical Journal

摘　　要：目的　探讨川崎病 (KD)患儿细胞免疫功能及静脉丙种球蛋白 (IVIG)治疗机制。方法　分别采用APAAP法、ELISA法和双抗体夹心酶联免疫吸附法对 60例KD患儿外周血T淋巴细胞亚群、血清白介素 2 (IL 2 )及可溶性白介素2受体 (sIL 2R)进行测定。患儿随机分为IVIG组和常规组各 3 0例。结果　与正常对照组相比 ,KD患儿急性期CD3 + 及CD3 + 百分率显著下降 (P <0 0 1) ,CD4+ 百分率、CD4+ /CD8+ 比值、血清IL -2及sIL 2R显著升高 (P <0 0 1)。经大剂量IVIG治疗后 ,各免疫学指标恢复明显 (P <0 0 1) ,冠脉病变发生率明显下降 (P <0 0 5 )。常规组治疗前后 ,各免疫学指标及冠脉病变发生率变化无明显差异 (P >0 0 5 )。结论　KD患儿急性期存在细胞免疫功能过度活化及免疫调节功能紊乱 ,IVIG可调节T细胞功能状态 ,使CD4+ 过度活化下调 ,并迅速达平衡状态 。Objective To study the cellular immune function and mechanisms of intravenous gammaglobulin(IVIG)in children with Kawasaki disease(KD).Methods T lymphocyte subcytes,levels of serum interleukin-2(IL-2)and soluble interleukin-2 receptor(sIL-2R)were determined by APAAP,ELISA method and a double-antibody 'sandwich' enzyme-linked immunosorbent assay technique respectively in 60 KD patients.30 cases are treated with both aspirin and IVIG,and others are treated only with conventional therapy as the conventional controls.Results ①During the acute stage of KD,the percentages of CD 4 +,the ratios of /CD 8 +,levels of IL-2 and sIL-2R increased markedly,while the percentages of CD 3 + and CD 8 + decreased significantly compared with the normaly controls(P<0.01).②Patients treated with IVIG have a significant increase in the percentages of CD 3 + and CD 8 +,a decrease in the percentages of CD 4 +,the ratios of CD 4 +/CD 8 +,levels of IL-2,levels of sIL-2R and incidence of the coronary artery diseases(P<0.05).Conclusion Mrked activation of cellular immune function and immune regulation disorders develop in the acute stage of KD patients and IVIG can reduce the coronary artery diseases effectively by regulating the balance of T lymphocyte subcytes and reversing the enhanced CD 4 + functions rapidly during the acute stage of KD patients.

关 键 词：川崎病 静脉丙种球蛋白 T细胞亚群 白介素2 可溶性白介素2受体 

分 类 号：R725.4[医药卫生—儿科]