肿瘤坏死因子-α和N末端脑利钠肽在川崎病患儿中的变化及临床意义  

Changes and Clinical Significance of Serum Tumor Necrosis Factor-α,N-Terminal Pro-Brain Natriuretic Peptide in Children with Kawasaki Disease

作　　者：洪泽[1] 孙兴珍[1] 程学英[2] 

机构地区：[1]南京医科大学附属淮安第一医院,江苏淮安223300 [2]南京医科大学附属南京儿童医院,江苏南京210008

出　　处：《儿科药学杂志》2016年第6期29-31,共3页Journal of Pediatric Pharmacy

摘　　要：目的:探讨血清肿瘤坏死因子-α(TNF-α)和N末端脑利钠肽(NT-pro BNP)在川崎病(KD)患儿中的临床意义。方法:选择确诊为KD的48例患儿为KD组,并选取年龄相仿的门诊体检健康儿童20例为对照组。采用双抗体夹心酶联免疫吸附法和全自动化学发光免疫分析仪对两组儿童血清TNF-α、NT-pro BNP和肌钙蛋白I(c Tn I)水平进行检测,并通过超声心动图检测冠状动脉情况,将KD组分为冠状动脉损害(CAL)组和无冠状动脉损害(NCAL)组。结果:急性期KD患儿的血清TNF-α、NTpro BNP和c Tn I水平分别为(2.11±0.76)μg/L、(0.88±0.19)μg/L、(0.28±0.16)μg/L,均显著高于恢复期KD组[(0.90±0.32)μg/L、(0.16±0.07)μg/L、(0.14±0.04)μg/L]和对照组[(0.75±0.38)μg/L、(0.12±0.05)μg/L、(0.13±0.05)μg/L]。CAL组血清TNF-α、NT-pro BNP和c Tn I水平分别为(2.83±0.45)μg/L、(0.97±0.19)μg/L、(0.35±0.19)μg/L,显著高于NCAL组的(1.67±0.54)μg/L、(0.83±0.17)μg/L、(0.24±0.13)μg/L。KD患儿急性期血清TNF-α、NT-pro BNP水平与c Tn I水平均呈显著正相关(r分别为0.641、0.731,P<0.01)。结论:血清TNF-α和NT-pro BNP水平与KD患儿的心血管损害关系密切,对预测KD患儿心肌和冠状动脉损伤有重要的临床价值。Objective： To explore levels of serum tumor necrosis factor-α（ TNF-α）,N-terminal pro-brain natriuretic peptide（ NTpro BNP） and its clinical significance in children with Kawasaki disease（ KD）. Methods： Forty-eight children with KD and twenty healthy children were enrolled. The levels of serum TNF-α,NT-pro BNP and cardiac tropnin I（ c Tn I） were measured by enzyme-linked immunosorbent assay,immune and automated chemiluminescence immunoassay,respectively. The KD group was divided into two subgroups,with or without coronary artery lesions,the coronary artery of KD group was checked by Doppler echocardiography. Results：In acute phase,the levels of serum TNF-α（（ 2. 11±0. 76） μg / L）,NT-pro BNP（（ 0. 88±0. 19） μg / L） and c Tn I（（ 0. 28±0. 16） μg / L）in children with KD were significantly higher than those in recovery phase [（ 0. 90±0. 32） μg / L,（ 0. 16±0. 07） μg / L,（ 0. 14±0. 04）μg /L] and control group（ 0. 75±0. 38） μg /L,（ 0. 12±0. 05） μg /L,（ 0. 13± 0. 05） μg /L]. The levels of serums TNF-α（（ 2. 83±0. 45） μg / L）,NT-pro BNP（（ 0. 97±0. 19） μg / L） and c Tn I（（ 0. 35±0. 19） μg / L） in children with CAL were significantly increased,compared with KD children without CAL（（ 1. 67±0. 54） μg / L）,（ 0. 83± 0. 17） μg / L,（ 0. 24± 0. 13） μg / L））. The levels of serum TNF-α,NT-pro BNP were positively correlated with the levels of c Tn I（ r = 0. 641,r = 0. 731,P 0. 01） in children with KD.Conclusion： The levels of serum TNF-α and NT-pro BNP are not only closely associated with cardiovascular damage but also can be taken as the indicators for diagnosis of myocardial damages and CALs in children with KD.

关 键 词：川崎病 肿瘤坏死因子-Α N末端脑利钠肽 心血管损害 

分 类 号：R725.4[医药卫生—儿科]