MMP-9、AECA、ANCA蛋白在川崎病外周血的表达及其与冠状动脉损害的关系  

Expression of MMP-9,AECA and ANCA in peripheral blood of patients with Kawasaki disease and its relationship with coronary artery lesions

作　　者：王晓华[1] 王倩[1] 赵建美[1] 

机构地区：[1]南通大学附属医院,江苏南通226001

出　　处：《山东医药》2016年第5期10-12,15,共4页Shandong Medical Journal

基　　金：江苏省卫生厅资助科研项目(H201423);2015年度南通市市级科技计划项目

摘　　要：目的探讨基质金属蛋白酶-9(MMP-9)、抗内皮细胞抗体(AECA)和抗中性粒细胞胞质抗体(ANCA)在川崎病(KD)冠状动脉损害中的作用及临床意义。方法选取KD患儿42例,分为冠脉损害(CAL)组16例,无冠脉损害(NCAL)组26例,以20例普通发热患儿、15例择期手术患儿作为对照组。ELISA检测各组血清MMP-9、AECA和ANCA蛋白水平;荧光定量PCR、明胶酶谱法分别测定单个核细胞MMP-9 m RNA表达及血清MMP-9酶活性。结果 KD急性期外周血MMP-9 m RNA表达、蛋白水平及酶活性均高于两对照组(P均<0.01),CAL组较NCAL组升高更显著(P均<0.05)。KD缓解期MMP-9 m RNA表达、蛋白水平及酶活性较急性期降低(P均<0.01)。KD急性期AECA、ANCA蛋白水平均高于两对照组(P均<0.01)。CAL组ANCA蛋白水平高于NCAL组(P<0.01)。KD急性期血清AECA水平与MMP-9呈正相关(r=0.77,P<0.01)。急性期CAL组MMP-9、ANCA与冠状动脉内径/主动脉瓣环内径比值呈正相关关系(r=0.57,P<0.05;r=0.88,P<0.01)。结果 MMP-9、AECA、ANCA蛋白参与KD血管炎及冠脉损害过程,检测其血清水平对早期预测冠脉损害有一定价值。Objective To investigate the potential role and clinical significance of matrix metalloproteinase 9（ MMP-9）,anti-endothelial cell antibodies（ AECA） and anti-neutrophil cytoplasmic antibodies（ ANCA） in vasculitis and coronary artery lesions（ CAL） of patients with Kawasaki disease（ KD）. Methods Forty-two children with KD were divided into two groups： CAL group（ n = 16） and non-coronary artery lesion（ NCAL） group（ n = 26）. Twenty febrile children and15 children for selective operation were chosen as the control group. Serum levels of MMP-9,AECA and ANCA were measured by enzyme-linked immunosorbent assay（ ELISA）,fluorescence quantitative-PCR and gelatin zymography were respectively used to detect MMP-9 m RNA expression and enzyme activity. Results The MMP-9 m RNA expression,protein level and enzymatic activity in the acute phase of KD patients were all higher than those in the two control groups（ all P 0. 01）,and they were significantly higher in the CAL group than in the NCAL group（ all P 0. 05）. Moreover,MMP-9m RNA expression,enzymatic activity and protein level were decreased significantly in the remission phase（ all P 0. 01）.Serum AECA and ANCA protein levels of KD patients in the acute phase were significantly higher as compared with those of the two control groups（ all P 0. 01）. The protein level of ANCA in the CAL group was significantly higher than that of the NCAL group（ P 0. 01）. There was a positive correlation between serum MMP-9 and AECA protein in the acute phase of KD（ r = 0. 77,P 0. 01）. The serum MMP-9 and ANCA protein levels of the CAL group in the acute phase were both positively correlated with LCA/AAO ratio（ r = 0. 57,P 0. 05; r = 0. 88,P 0. 01）. Conclusions MMP-9,AECA and ANCA are potential pathological factors in the formation of KD vasculitis and CAL. The serum level detection has a certain value for early prediction of CAL.

关 键 词：川崎病 基质金属蛋白酶-9 抗内皮细胞抗体 抗中性粒细胞胞质抗体 冠状动脉损害 

分 类 号：R725.4[医药卫生—儿科]