丙种球蛋白无反应型川崎病患儿淋巴细胞亚群、肿瘤坏死因子-α检测的意义  

Study of Lymphocyte Subsets and Tumor Necrosis Factor-α Levels and Its Role in Intravenous Immunoglobulin Non-responsive Children with Kawasaki Disease

作　　者：陈雪贞 周小琳[1] 叶佳云 梁欢欣 廖雄宇 钟奕 覃丽君[1] CHEN Xue-zhen;ZHOU Xiao-lin;YE Jia-yun;LIANG Huan-xin;LIAO Xiong-Yu;ZHONG Yi;QIN Li-jun(Department of Pediatric,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,510120)

机构地区：[1]中山大学孙逸仙纪念医院儿科,510120

出　　处：《岭南急诊医学杂志》2018年第4期331-333,共3页Lingnan Journal of Emergency Medicine

基　　金：广东省科技计划项目(2014A020212132)

摘　　要：目的:检测丙种球蛋白无反应型川崎病患儿外周血淋巴细胞亚群、肿瘤坏死因子-α(TNF-α)的变化,为IVIG无反应型KD患儿的诊断提供依据。方法:80例KD患儿,发病10天内接受IVIG标准治疗,对IVIG无反应组与敏感组患儿间外周血淋巴细胞亚群、TNF-α水平的差异进行比较。结果:外周CD4^+/CD8^+、CD3^+CD4^+、CD3^-CD19^+、TNF-α水平无反应组明显高于敏感组,差异有统计学意义(P<0.05);CD3^+CD8^+、CD3^+明显低于敏感组,差异有统计学意义(P<0.05);CD3^-(CD16^+CD56)^+、CD20两组间差异无统计学意义(P>0.05)。结论:相对于敏感型患儿,丙种球蛋白无反应型川崎病患儿外周血淋巴细胞亚群、TNF-α有更明显的异常,为早期诊断丙种球蛋白无反应型川崎病提供重要依据和参考指标,同时有助于预测KD患儿冠状动脉损害的发生几率。Objective： To study the changes of lymphocyte subsets and tumor necrosis factor-α（TNF-α）of intravenous immunoglobulin（IVIG）non-responsive children with Kawasaki disease,and to explore further treatment of IVIG non-responsive. Methods：Eighty patients with KD received initial IVIG and aspirin therapy within 10 days,Patients were divided into non-responsive group and sensitive group,while the clinical experiences and the outcome of them were recorded,and the levels of lymphocyte subsets,TNF-α in KD patients were compared within different groups. Results：In non-responsive group,the rate of coronary artery lesions（CALs）was 80%（8/10 cases）in non-responsive group,when 57%（40/70 cases）in sensitive group,there was a statistical difference between them（P〈0.05）. Compared with the sensitive group,the levels of CD4~＋/CD8~＋,CD3~＋CD4~＋,CD3^-CD19~＋,TNF-α were significantly higher,whereas the level of CD3~＋CD8~＋,CD3~＋was significantly lower in non-responsive group（all P〈0.05）,and the level of CD3^-（D16~＋CD56）~＋,CD20 didn＇t have significant change（P〉0.05）. Conclusion：Peripheral blood lymphocyte subsets and TNF-α can change in patients with Kawasaki disease who are intolerant to IVIG,which should be carefully considered during treatment. It provides an important basis for early prediction of the IVIG non-responsive group and can also be used as an important reference index for predicting coronary artery lesions in children with KD.

关 键 词：川崎病 丙种球蛋白无反应型 淋巴细胞亚群 肿瘤坏死因子-Α 

分 类 号：R725.4[医药卫生—儿科]