川崎病患儿血清降钙素原、超敏C反应蛋白及淋巴细胞亚群CD19＋CD23＋检测的临床意义  

The clinical significance of serum levels of procalcitonin, C reactive protein, and lymphocyte subsets CD19＋CD23＋ in children with Kawasaki disease

作　　者：侯秋英[1] 沈方方[1] 朱雯[1] 滕懿群[1] 

机构地区：[1]嘉兴市第二医院儿科,浙江省嘉兴314200

出　　处：《中国基层医药》2016年第3期361-364,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省嘉兴市科技局计划项目（2012AY1071-12）

摘　　要：目的检测川崎病（KD）患儿治疗前后血清降钙素原（PCT）、超敏C反应蛋白（CRP）、淋巴细胞亚群CD19＋CD23＋的变化，探讨其临床意义。方法选取2013年8月至2015年7月住院的急性期KD患儿30例，根据心脏彩超结果分为冠状动脉病变（CAL）组和非冠状动脉病变（NCAL）组，每组各15例，分别检测静脉丙种球蛋白（IVIG）治疗前后血清PCT、CRP、CD19＋CD23＋水平，并以同期健康体检儿童30例作为健康对照组进行比较。血清PCT检测采用电化学发光免疫分析法，CRP测定采用免疫乳胶比浊法，CD19＋CD23＋测定采用流式细胞仪。结果KD患儿IVIG治疗前PCT、CRP、CD19＋CD23＋分别为（1．37±0．39）μg/L、（52．24±12．99）mg／L、（25．45±11．06）％，均明显高于KD治疗后的[（0．49±0．24）μg/L、（37．48±6．27）mg／L、（17．23±1．97）％]和健康对照组的（0．05±0．00）μg/L、（16．08±5．21）mg／L、（15．76±2．39）％，差异均有统计学意义（均P〈0．01）。CAL组PCT、CRP分别为（1．75±0．53）μg/L、（65．95±14．55）mg／L，均高于NCAL组的（0．93±0．42）μg/L、（26．18±6．71）mg／L，差异均有统计学意义（t=5．504、5．621，均P〈0．05），而CAL组CD19＋CD23＋[（24．70±11．86）％]水平与NCAL组[（25．79±10．59）％]比较差异无统计学意义（t=0．559，P〉0．05）。结论PCT、CRP、CD19＋CD23＋可作为KD早期诊断及预测病情的重要指标，其中PCT、CRP水平对冠脉损害的评估具有临床意义。Objective To investigate the clinical significance of serum procalcitonin （PCT）, C reactive pro- tein（CRP）, and lymphocyte subsets CD19＋CD23＋ in children with Kawasaki disease （KD）. Methods From August 2013 to July 2015 in hospital,30 cases of acute phase KD were selected. According to cardiac color Doppler ultrasound results,30 patients were divided into coronary artery disease （CAL） group and non coronary artery disease （NCAL） group. The intravenous immunoglobulin （IVIG） before and after treatment, serum PCT, CRP, CD19＋CD23＋ were detected. And 30 healthy children were selected as normal control group. Serum PCT was detected by chemiluminescence immunoassay, CRP was determined by immune latex ratio method, CD19＋CD23＋ was measured by flow cytometry. Results The levels of PCT, CRP and CD19＋CD23＋ were （ 1.37 ± 0.39 ） μg/L, （ 52.24 ± 12.99 ） mg/L, （ 25.45±11.06）% respectively in KD before IVIG treatment,which were significantly higher than those of KD after treatment [ （0.49 ± 0.24） μg/L, （37.48 ± 6.27 ） rag/L, （ 17.23 ± 1.97 ） % ] and the control group [ （0.05 ±0.00 ） μg/L, （ 16. 08 ± 5.21 ） mg/L, （ 15.76 ± 2.39 ） % ], the differences were statistically significant （ t = 6. 108,5. 983,8. 172, all P 〈 0.01 ）. In CAL group, PCT [ （ 1.75 ± 0. 53 ） μg/L, （ 65.95 ±14.55 ） mg/L ] and CRP [ （ 0. 93 ± 0.42） μg/L, （26. 18 ± 6.71 ）mg,/L] were higher than NCAL group,the differences were statistically significant （t = 5. 504,5. 621, all P 〈 0.05 ）. While CAL group CD19＋CD23＋[ （ 24.70 ± 11.86 ） % ] and NCAL group [ （ 25.79 ± 10.59 ） % ] had no statisticaUy significant difference（t =0.559,P〉0.05）. Conclusion PCT, CRP and CD19＋CD23＋ can be used as important index for early diagnosis and prediction of KD, the levels of CRP and PCT have clinical significance in the assessment of coronary artery lesions.

关 键 词：皮肤黏膜淋巴结综合征 C反应蛋白质 降钙素原 冠状动脉 

分 类 号：R725.4[医药卫生—儿科]