血清白细胞介素、抗心磷脂抗体和抗血管内皮细胞抗体检测在川崎病患儿中的应用  

Application of serum interleukin, anti-cardiolipin antibody and anti-endothelial cell antibody detection in children with Kawasaki disease

作　　者：孙晓晗[1] 任立红[1] 胡孟英[1] 高慧[1] 王志会[1] 

机构地区：[1]哈尔滨医科大学附属第二医院小儿内科,150086

出　　处：《中国医师进修杂志》2017年第11期970-974,共5页Chinese Journal of Postgraduates of Medicine

基　　金：黑龙江省卫生计生委基金（2014-311）

摘　　要：目的 探讨川崎病患儿血清白细胞介素（IL）-33、21、17、6水平及抗心磷脂抗体（ACA）-IgG、ACA-IgM和抗血管内皮细胞抗体（AECA）-IgM阳性在川崎病的诊断及预测冠状动脉损害中的意义.方法 选取川崎病患儿70例（川崎病组）,按照心脏超声是否异常分为超声异常组（11例）和超声正常组（59例）;另外选取50例上呼吸道感染或支气管炎患儿作为对照组.均检测血清IL-33、21、17、6水平及ACA-IgG、ACA-IgM、AECA-IgM阳性情况.结果 川崎病组急性期血清IL-33、21、17、6水平均明显高于对照组[（127.43±10.87）ng/L比（69.67±6.38）ng/L、（130.43±11.22）ng/L比（87.56±7.76）ng/L、（1243.38±612.08）ng/L比（397.26±182.16）ng/L、（438.35±101.78）ng/L比（213.74±104.52）ng/L],ACA-IgG、IgM和AECA-IgM阳性率均明显高于对照组[37.1%（26/70）比8.0%（4/50）、32.9%（23/70）比6.0%（3/50）、34.3%（24/70）比8.0%（4/50）],差异有统计学意义（P〈0.01）.超声异常组急性期血清IL-33、21、17、6水平均明显高于超声正常组[（135.92±11.56）ng/L比（123.48±10.14）ng/L、（138.29±11.86）ng/L比（128.08±10.94）ng/L、（2042.47±968.43）ng/L比（1096.59±502.82）ng/L、（495.58±103.04）ng/L比（402.67±98.26）ng/L],ACA-IgG、IgM和AECA-IgM阳性率均明显高于超声正常组[7/11比32.2%（19/59）、8/11比25.4%（15/59）、7/11比28.8%（17/59）],差异有统计学意义（P〈0.01或〈0.05）.川崎病组急性期血清IL-33、21、17、6水平均明显高于亚急性期[（127.43±10.87）ng/L比（94.48±8.56）ng/L、（130.43±11.22）ng/L比（91.78±8.03）ng/L、（1243.38±612.08）ng/L比（527.12±236.94）ng/L、（438.35±101.78）ng/L比（308.41±144.09）ng/L],差异有统计学意义（P〈0.01）.结论 IL-33、21、17、6及ACA-IgG、ACA-IgM、AECA-IgM参与川崎病血管炎及冠状动脉损害过程,可以辅助川崎病早期诊断及预测冠状动脉损害的发生.Objective To explore the significance of serum levels of interleukin（IL）-33,21,17, 6,the positive rates of anti-cardiolipin antibody（ACA）-IgG,ACA-IgM and anti endothelial cell antibody （AECA）-IgM in diagnosis of Kawasaki disease and prediction of coronary artery lesions. Methods Seventy children with Kawasaki disease were selected as Kawasaki disease group,and the children were divided into abnormal ultrasonic group（11 cases）and normal ultrasonic group（59 cases）according to the result of cardiac ultrasound. Fifty children with upper respiratory tract infection or bronchitis were selected as control group.The serum levels of IL-33,21,17,6 and positive rates of ACA-IgG,ACA-IgM, AECA-IgM were detected.Results The serum levels of IL-33,21,17 and 6 in Kawasaki disease acute stage were significantly higher than those in control group：（127.43 ± 10.87）ng/L vs.（69.67 ± 6.38）ng/L, （130.43 ± 11.22） ng/L vs. （87.56 ± 7.76） ng/L, （1 243.38 ± 612.08） ng/L vs. （397.26 ± 182.16） ng/L, （438.35 ± 101.78）ng/L vs.（213.74 ± 104.52）ng/L;the positive rates of ACA-IgG,ACA-IgM and AECA-IgM were significantly higher than those in control group： 37.1%（26/70）vs.8.0%（4/50）,32.9%（23/70） vs.6.0%（3/50）and 34.3%（24/70）vs.8.0%（4/50）,and there were statistical differences（P〈0.01）.The acute stage serum levels of IL-33, 21, 17 and 6 in abnormal ultrasonic group were significantly higher than those in normal ultrasonic group：（135.92 ± 11.56）ng/L vs.（123.48 ± 10.14）ng/L,（138.29 ± 11.86） ng/L vs.（128.08 ± 10.94）ng/L,（2 042.47 ± 968.43）ng/L vs.（1 096.59 ± 502.82）ng/L,（495.58 ± 103.04） ng/L vs. （402.67 ± 98.26） ng/L; the positive rates of ACA-IgG, ACA-IgM and AECA-IgM were significantly higher than those in normal ultrasonic group：7/11 vs.32.2%（19/59）,8/11 vs.25.4%（15/59） and 7/11 vs. 28.8% （17/59）, and there were statistical differences （P 〈 0.01 or 〈0.05）. In Kawasaki disease, the acute stage seru

关 键 词：黏膜皮肤淋巴结综合征 白细胞介素类 抗心磷脂抗体 抗血管内皮细胞抗体 

分 类 号：R446.6[医药卫生—诊断学] R725.4[医药卫生—临床医学]