血清白介素23和前清蛋白及高密度脂蛋白胆固醇在不完全川崎病患儿中的临床意义  

Clinical Significance of IL-23,Pre-albumin and High-density Lipoprotein Cholesterol in Patients With Incomplete Kawasaki Disease

作　　者：吴菱[1,2] 俞晗春[2] 陈圆玲[2] 钟世玲 狄亚珍[2] 孙楠[1] 王佳佩 沈梦娇[1] 

机构地区：[1]宁波大学医学院,浙江省宁波市315000 [2]宁波市妇女儿童医院小儿风湿免疫科

出　　处：《中国全科医学》2015年第36期4437-4443,共7页Chinese General Practice

基　　金：浙江省医药卫生科学研究基金资助项目(2008B168)

摘　　要：目的观察典型川崎病(KD)及不完全川崎病(IKD)患儿血清白介素23(IL-23)、前清蛋白(PA)、高密度脂蛋白胆固醇(HDL-C)水平变化,探讨其在IKD患儿中的临床意义。方法选择2012年9月—2013年7月于宁波市妇女儿童医院小儿风湿免疫科住院的KD患儿56例为病例组。根据诊断结果分为典型KD组(45例)和IKD组(11例);根据超声心动图结果是否异常分为超声心动图异常组(心超阳性组,11例)及超声心动图正常组(心超阴性组,45例)。同期选取宁波市妇女儿童医院因呼吸道感染住院的患儿30例为对照组。收集患儿的临床指标,检测血清IL-23、PA、清蛋白(ALB)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、HDL-C、C反应蛋白(CRP)水平。结果典型KD组与IKD组性别、年龄、总热程、首次应用丙种球蛋白时间、唇及口腔改变发生率、颈部淋巴结肿大发生率、手足硬肿发生率、指趾端脱皮发生率、肛周脱皮发生率、卡疤红发生率、IL-23、PA、ALB、TG、TC、LDL-C、HDL-C、CRP水平比较,差异无统计学意义(P>0.05);典型KD组超声心动图结果异常发生率、皮肤改变发生率、结膜充血发生率与IKD组比较,差异有统计学意义(P<0.05)。KD患儿急性期IL-23、CRP水平高于缓解期,PA、ALB、TG、TC、LDL-C、HDL-C水平低于缓解期(P<0.05)。病例组KD患儿急性期IL-23、CRP水平高于对照组,PA、ALB、HDL-C水平低于对照组(P<0.05);KD患儿急性期TG、TC、LDL-C水平与对照组比较,差异无统计学意义(P>0.05)。心超阳性组与心超阴性组性别、总热程、TG、TC、LDL-C水平比较,差异无统计学意义(P>0.05);心超阳性组年龄、首次应用丙种球蛋白时间、IL-23、PA、ALB、HDL-C、CRP水平与心超阴性组比较,差异有统计学意义(P<0.05)。KD患儿急性期IL-23水平与ALB水平呈负相关,与CRP水平呈正相关(P<0.05);KD患儿急性期PA水平与ALB、HDL-C水平呈正相关,与CRP水平呈负相关(P<0.0Objective To investigate the clinical significance of serum interleukin 23 （ IL - 23 ） , pre - albumin （PA） and high density lipoprotein cholesterol （ HDL - C） levels in patients with complete Kawasaki disease （ KD ） or incomplete KD （IKD） . Methods Recruited a total of 56 children patients with KD who were admitted into the Department of Pediatric Rheumatoid Immunology of Ningbo Women and Children＇s Hospital from September 2012 to July 2013. Among these patients, 45 were diagnosed with complete KD and l I with IKD. These patients were divided into echocardiography abnormal group（ echocardiography - positive, n -- 11 ） and normal group （ echocardiography - negative, n = 45 ） according to the results of echocardiography. In the same period, we enrolled 30 patients with respiratory infections mainly including upper respiratory infections and bronchitis. The clinical indicators of the patients were collected. The level of IL - 23, PA, albumin （ ALB ） , triglyeerides （ TG）, total cholesterol （ TC ）, low density lipoprotein cholesterol （ LDL - C ）, HDL - C and C - reactive protein （CRP） were detected. Results KD group and IKD group were not significantly different in age, gender, the total duration of fever, the time of the first application of intravenous gamma globulin, the enlargement of cervical lymph nodes, the incidence rates of hard swollen hands and feet, membranous desquamation from fingertips, anus decrustation, redness and crust at the site of BCG inoculation and the levels of IL - 23, PA, ALB, TG, TC, LDL - C, HDL - C and CRP （P 〉 0.05） ; KD group was significantly different （ P 〈 0. 05 ） from IKD group in the incidence rates of abnormality of ultrasonic cardiogram, skin change and conjunctival congestion. The levels of IL- 23 and CRP of KD group in acute stage were higher than that in remission, and the levels of PA, ALB, TG, TC, LDL - C and HDL - C of KD group in acute stage were higher than that in remission （P 〈 0. 05 ）. KD group was h

关 键 词：黏膜皮肤淋巴结综合征 白介素23 前清蛋白 脂蛋白类 

分 类 号：R72[医药卫生—儿科]