川崎病免疫功能和炎症因子检测及临床意义  

Immune function and inflammatory factor examination and their clinical significances in Kawasaki disease

作　　者：沈方方[1] 章爱莲[1] 朱雯[1] 滕懿群[1] 

机构地区：[1]嘉兴市第二医院,浙江嘉兴314501

出　　处：《中国妇幼健康研究》2015年第6期1201-1203,共3页Chinese Journal of Woman and Child Health Research

基　　金：嘉兴市科技局资助项目(2012AY1071-12)

摘　　要：目的分析川崎病免疫功能及炎症因子,探讨细胞免疫、体液免疫及炎症因子在川崎病中的机制及临床价值。方法对56例川崎病患儿及50例健康对照组儿童测定免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、补体C3、补体C4水平,用流式细胞仪免疫荧光法检测CD3^+T细胞百分比(CD3^+%)、CD4^+T细胞百分比(CD4^+%)、CD8^+T细胞百分比(CD8^+%)、CD4^+/CD8^+、CD19^+T细胞百分比(CD19^+%)、自然杀伤细胞百分比(NK%)。采用双抗体夹心酶联免疫吸附法(ELISA)测定炎症因子肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)、白介素-10(IL-10)。统计学方法采用2个独立样本t检验。结果 56例川崎病与50例健康对照组比较,CD8^+%明显降低,CD4^+/CD8^+比值倒置、CD19^+%明显升高,NK%降低,IgG升高,均具有统计学意义(t值分别为5.31、6.12、4.65、5.51、2.13,均P<0.01)。18例患儿急性期TNF-α、IL-6、IL-10较恢复期明显升高,差异均有统计学意义(t值分别为2.59、2.60、2.53,均P<0.05)。急性期TNF-α、IL-6、IL-10在合并有冠脉损害组较无冠脉损害组均明显升高,差异均有统计学意义(t值分别为4.13、2.77、6.11,均P<0.05)。结论川崎病急性期存在细胞及体液免疫功能的紊乱,炎症因子参与了川崎病的发病机制。尤其是冠脉损害的KD患儿炎症因子显著升高。Objective To analyze the immune function and inflammatory factors in Kawasaki disease （KD） and explore the pathological mechanism and clinical value of cellular immunity, humoral immunity and inflammatory factors in KD. Methods The serum IgG, IgM, IgA and C3, CA levels were detected in 56 children with DK and 50 healthy controls. Flow cytometry was used to analyze the proportion of CD3＋T （CD3＋%）, CD4＋T （CD4＋%）, CD8＋T （CD8＋%）, CD4＋/CD8＋, CD19＋T （CD19＋%） andNK （NK%）. ELISA was used to detect TNF-α, IL-6 and IL-10. Independent t-test was adopted to analyze data. Results Compared with 50 healthy controls, CD8 ＋ % decreased significantly, the ratio of CIM/CD8 inverted, CD19 ＋ % increased obviously, NK% declined and IgG rose in 56 cases of KD with statistical significance （ t value was 5.31,6.12, 4.65, 5.51 and 2.13, respectively, all P 〈 0.01 ）. In the acute phase, the levels of TNF-α, IL-6 and IL-10 were significantly higher than those in the recovery phase （t value was 2. 59, 2. 60 and 2. 53, respectively, all P 〈0.05）. In the coronary arterial lesion （CAL） subgroup, the levels of TNF-a, IL-6 and IL-10 were higher than those in the non-CAL subgroup, and the differences were significant （t value was 4. 13, 2.77 and 6. 11, respectively, all P 〈 0.05 ）. Conclusion The cellular immunity and humoral immunity disturbances occur in acute phase of KD, and inflammatory factors are important in the pathogenesis of the KD. KD cases with CAL have especially higher level of inflammatory factors.

关 键 词：川崎病 淋巴细胞亚群 炎症因子 肿瘤坏死因子Α 

分 类 号：R725[医药卫生—儿科]