川崎病患儿ES和MMP-9水平的动态变化及临床意义  

Change in serum level of soluble E-selectin and MMP-9 in children with Kawasaki disease

作　　者：陈刚[1] 于明华[1] 曾华松[1] 张丽[1] 韦茹[1] 刘威[1] 陈兆鸿[1] 刘特长[1] 

机构地区：[1]广州市儿童医院心血管科,510120

出　　处：《广州医药》2008年第2期24-27,共4页Guangzhou Medical Journal

基　　金：广东省科学技术厅基金项目(编号:63097);广州市卫生局一般引导项目(编号:2006-YB-070)

摘　　要：目的探讨E选择素(E-selectin,ES)、基质金属蛋白酶9(matrix metalloproteinase 9,MMP-9)与小儿川崎病血管损伤中的相互关系,为探讨冠状动脉(简称冠脉)损伤的机制寻找直接的依据。方法应用酶联免疫吸附实验(ELISA)双抗体夹心法检测68例川崎病(KD)患儿、并随机选择同年龄段20例发热疾病患儿、20例健康对照组儿童进行对比测量ES、MMP-9,并将KD患儿分为急性期、亚急性期、恢复期;有冠脉损伤(CAL)组与无冠脉损伤(NCAL)组进行对比研究。结果KD患儿组的ES、MMP-9急性期、亚急性期均高于健康对照组和发热组,各组间差异有显著性(P<0.01);ES、MMP-9高峰期在急性期。CAL组急性期ES、MMP-9水平明显高于NCAL,差异有显著性(P<0.01)。急性期ES与MMP-9水平存在显著正相关(r=0.643,P<0.01)。结论ES、MMP-9在川崎病患儿血管损伤的病理生理发生机制中起重要作用,ES、MMP-9具有预示KD患儿CAL潜在的可能性。Objective Kawasaki disease （KD） is a kind of febrile disorder without definite etiology. Coronary artery aneurysms are the major complication of Kawasaki disease （KD） . The pathogenesis of the vascular damage remains unknown. This study was conducted to explore the pathophysiological role of E-selectin （ ES）, Matrix metalloproteinase 9 （ MMP-9 ） in KD, and to look for the evidence of direct relationship between the plasma levels of ES, MMP-9 and the incidence of the coronary artery lesion （CAL） . Methods Soluble ES and MMP-9, were measured in 68 patients with KD, 20 patients with febrile disease and 20 healthy children by using double antibody sandwich enzyme linked immunosorbent assay （ELISA） . Patients with KD were separated into acute phase group, subacute phase group, recovery phase group, coronary artery lesion group （CAL）, non-coronary artery lesion group （NCAL） Results ES and MMP-9 levels in the acute phase group, subacute phase group were significantly higher than those in the healthy group. Plasma ES and MMP-9 levels of CAL group were signifi- cantly higher than those of NCAL group in acute phase. The peak level of ES and MMP-9 appeared in the acute phase. There was a significant correlation between ES and MMP-9 levels in KD patients （r =0.643, P 〈 0. 01 ）, Conclusion The increase of plasma PS and ES levels in KD acute phase and subacute phase might play an important role in the pathophysiology of the vascular damage. ES and MMP-9 may potentially be a predictor of CAL in patients.

关 键 词：川崎病 E选择素 基质金属蛋白酶9 

分 类 号：R725.4[医药卫生—儿科]