血浆内皮微粒水平变化与川崎病冠状动脉损伤关系的研究  

Changes of endothelial microparticles in children with Kawasaki disease and its relation to coronary artery lesions

作　　者：姚翠翠[1] 王策[1] 于宪一[1] 

机构地区：[1]中国医科大学附属盛京医院小儿心脏科,沈阳110004

出　　处：《中国小儿急救医学》2012年第2期158-160,共3页Chinese Pediatric Emergency Medicine

基　　金：辽宁省教育厅科学研究项目（2008805）;沈阳市科学技术项目（F11.264-1-30）

摘　　要：目的通过观察川崎病患儿血浆内皮微粒（endothelialmicroparticle，EMP）水平的变化，确定EMP水平变化与川崎病冠状动脉损伤的关系，探讨EMP测定在早期诊断冠状动脉损伤中的价值。方法30例川崎病患儿均符合日本川崎病研究委员会第4次修订的诊断标准，其中24例为完全型川崎病，6例为不完全型川崎病，并按病程分为急性期、亚急性期、恢复期。根据超声心动图将川崎病组又分为冠状动脉损伤组（6例）和冠状动脉无损伤组（24例）。以10例发热伴有皮疹的患儿及10例健康儿童为发热对照组和正常对照组。采用流式细胞术检测血浆中CD31＋／CD42b—EMP水平。结果川崎病患儿急性期血浆EMP水平[（8．18±2．29）％]明显高于恢复期[（2．77±0．85）％]和正常对照组[（1．34±0．38）％]（P〈0．01）；亚急性期血浆EMP水平[（5．93±1．05）％]明显高于恢复期和正常对照组（P〈0．01）；发热对照组血浆EMP水平[（3．66±1．16）％]高于正常对照组（P〈0．05）；急性期川崎病患儿中冠状动脉损伤组血浆EMP水平高于冠状动脉无损伤组，差异有统计学意义（P〈0．01）。结论血浆EMP的检测分析有助于川崎病的早期诊断及冠状动脉损伤的早期发现。Objective To study the changes of plasma endothelial microparticles （EMP） in children with Kawasaki disease （KD） and its relation to coronary artery lesions （CAL）. Methods The participants in this study were 30 children with KD （24 children with typical KD and 6 cases with incomplete KD）. All KD patients met the diagnostic criteria established by the Japanese Kawasaki Disease Research Committee. According to the course of KD,3 phases were divided：the acute phase, the subacute phase and the convalescent phase. We evaluated the presence of CAL using two-dimensional echocardiographic examination, and then the KD children were divided into two groups, including 24 children without CAL and 6 children with CAL. Ten children with fever and rash and 10 healthy children were studied as control. The levels of CD31＋/ CD42b- EMP were measured by flow cytometry. Results The level of EMP was significantly higher in the acute phase [ （8.18 ± 2. 29） % ] than those either in the convalescent phase （2. 77 ± 0. 85 ） % ] of KD or the healthy children [ （ 1.34 ± 0. 38 ） % ] （ P 〈 0. 01 ）. The level of EMP was also significantly higher in the subacute phase [ （5.93 ± 1.05 ） % ] than those either in the convalescent phase of KD or the healthy children （ P 〈0.01 ）. The level of EMP was higher in the children with fever [ （ 3.66 ± 1.16 ） % ] than that in the healthy children （ P 〈 0. 05 ）. Furthermore, the level of EMP during the acute phase was also higher in KD pa- tients with CAL than in those without CAL （P 〈 0. 01 ）. Conclusion The measurement of EMP may be useful for the early diagnosis of KD and the identification of CAL.

关 键 词：川崎病 内皮微粒 流式细胞术 冠状动脉损伤 

分 类 号：R725.4[医药卫生—儿科]