心型脂肪酸结合蛋白在川崎病患儿中的变化及其临床意义  

Levels of serum heart-type fatty acid-binding protein and its clinical significance in children with Kawasaki disease

作　　者：孙裕平 王文棣 王金菊 王丽燕 

机构地区：[1]青岛市儿童医院内一科,山东青岛266011

出　　处：《中国当代儿科杂志》2008年第2期136-138,共3页Chinese Journal of Contemporary Pediatrics

摘　　要：目的通过测定川崎病(KD)患儿血清心型脂肪酸结合蛋白(h-FABP)水平变化,以探讨h-FABP在反映KD患儿心肌损害中的临床价值。方法选择40例KD患儿为研究对象,以30例正常儿童为对照组。对KD组及对照组采用酶联免疫吸附法检测血清h-FABP、肌钙蛋白I(cTnI),同时利用杜邦全自动生化分析仪检测肌酸磷酸激酶同功酶(CK-MB)。并行心脏彩色多普勒(UCG)检测冠状动脉内径,将KD组分为冠状动脉病变(CAL)组和非冠状动脉病变(NCAL)组。结果KD组血清h-FABP浓度、阳性率与对照组比较差异有显著性(P<0.01),cTnI浓度及阳性率明显高于对照组(P<0.05),而CK-MB浓度和阳性率与对照组比较差异无显著性(P>0.05);h-FABP与cTnI阳性率比较差异有显著性(P<0.01);CAL组和NCAL组血清h-FABP浓度对比差异有显著性(P<0.01)。结论血浆h-FABP、cTnI浓度可作为KD患儿早期心肌损害的生化标志物,而h-FABP具有更高的灵敏度和特异性;血浆h-FABP浓度对川崎病以及川崎病合并冠状动脉病变的早期诊断、指导治疗具有重要的临床意义。Objective This study examined serum level of heart-type fatty acid-binding protein （h-FABP） in children with Kawasaki disease （KD） in order to assess its value in KD. Methods Forty children with KD and 30 healthy children were enrolled. Serum levels of h-FABP and cardiac troponin I （cTnI） were measured using ELISA. Serum creatine kinase- MB （CK-MB） level was detected using an autoanalyer. The KD group was classified into two subgroups, with or without coronary artery lesions, based on the findings of the echocardiography. Results Mean serum levels of h-FABP （ 18.17 ± 13.38 ng/mL vs 6.25 ±1.70 ng/mL; P〈0.01） and cTnI （0.27 ±0.22 ng/mL vs 0.11 ±0.02 ng/mL; P〈0.05） in the KD group was significantly higher than those in the control group. There was no significant difference in serum CK-MB concentrations between the two groups. Twenty-six patients （65%） and eight patients （20%） showed abnormally increased h-FABP and cTnI levels respectively in the KD group, but none of the control group showed increased levels of both. In the KD group, the percentage of patients with increased h-FABP was significantly higher than those with increased CTnI （P 〈0.01 ）. The patients with coronary artery lesions had higher serum h-FABP level than those without （28.14 ± 14.26 ng,/mL vs 11.52 ±6.28 ng/mL; P 〈 0.01 ）. Conclusions Serum levels of h-FABP and cTnI increase and can be used as the biomarkers of myocardial damage in children with KD. h-FABP appears to be more sensitive and specific. Detection of serum h-FABP level is useful for diagnosis of KD and coronary artery lesions secondary to KD.

关 键 词：川崎病 脂肪酸结合蛋白 肌钙蛋白 肌酸磷酸激酶同功酶 心肌损伤 儿童 

分 类 号：R725.4[医药卫生—儿科]