细胞因子在川崎病中的临床意义  

Clinical significance of cytokines in children with Kawasaki disease

作　　者：胡具雄 卢一斌 马效东[1] 肖辉 汪伟[2] HU Juxiong;LU Yibin;MA Xiaodong(Department ofPediatrics,Yuhang Third People’s Hospital,Hangzhou 311115,China)

机构地区：[1]杭州市余杭区第三人民医院儿科,311115 [2]浙江大学医学院附属儿童医院儿科

出　　处：《浙江医学》2020年第11期1135-1137,1142,共4页Zhejiang Medical Journal

基　　金：杭州市卫生科技计划项目(2017B35)。

摘　　要：目的探讨细胞因子在川崎病中的临床意义。方法选取2017年6月至2018年12月杭州市余杭区第三人民医院收治的50例川崎病患儿为川崎病组,选取同期收治的50例普通发热、淋巴结肿大的非川崎病感染发热患儿为感染发热组,50例健康儿童为健康对照组。比较3组对象外周血T淋巴细胞亚群(CD3+、CD4+、CD4+/CD8+)、血清炎症细胞因子及其他指标[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、干扰素γ(IFN-γ)、巨噬细胞迁移抑制因子(MIF)、C反应蛋白(CRP)、红细胞沉降率(ESR)]水平。同时观察川崎病患儿在急性期(发病第1~11天)、亚急性期(发病第11~21天)及恢复期(发病第21~60天)上述指标的变化。结果川崎病组T淋巴细胞亚群(CD4+、CD4+/CD8+)以及IL-6、TNF-α、IFN-γ、MIF、CRP、ESR水平均明显高于感染发热组、健康对照组(均P<0.05)。川崎病患儿急性期T淋巴细胞亚群(CD4+、CD4+/CD8+)以及IL-6、TNF-α、IFN-γ、MIF、CRP、ESR水平均明显高于亚急性期和恢复期(均P<0.05),而亚急性期上述指标又明显高于恢复期(均P<0.05)。结论川崎病患儿存在T淋巴细胞亚群失衡与炎症反应,相关指标随病情进展而呈上升趋势。炎症细胞因子结合T淋巴细胞亚群检测,能辅助评估川崎病的病情进展及治疗效果。Objective To explore the clinical significance of cytokines in children with Kawasaki disease.Methods Fifty children with Kawasaki disease admitted to the Third People's Hospital of Hangzhou Yuhang District from June 2017 to December 2018(Kawasaki group),and 50 children with common fever and lymphadenopathy admitted during the same period(non-Kawasaki fever group),and 50 healthy children(healthy control group)were included in the study.The peripheral blood T lymphocyte subsets(CD3+,CD4+,CD4+/CD8+),serum IL-6,TNF-α,IFN-γ,macrophage migration inhibitory factor(MIF),C-reactive protein(CRP)and erythrocyte sedimentation factor(ESR)levels were compared among three groups.The changes of the above indexes were observed in children with Kawasaki disease during the acute phase(d 1-11 of onset),subacute phase(d11-21 of onset)and recovery period(d 21-60 of onset).Results The levels of T lymphocyte subsets(CD4+,CD4+/CD8+)and IL-6,TNF-α,IFN-γ,MIF,CRP,ESR in the Kawasaki group were significantly higher than those in non-Kawasaki fever group and healthy control group(P<0.05).The levels of T lymphocyte subsets(CD4+,CD4+/CD8+)and IL-6,TNF-α,IFN-γ,MIF,CRP,ESR in Kawasaki group in acute phase were significantly higher than those in subacute phase and recovery period(P<0.05),and the above indicators in the subacute phase were significantly higher than those in the recovery period(P<0.05).Conclusion In children with Kawasaki disease,there is an imbalance of T lymphocyte subsets and inflammation,and the related indicators are increased with the progression of the disease.Inflammatory cytokines combined with the detection of T lymphocyte subsets may assist in assessing the progression of Kawasaki disease and the therapeutic effect.

关 键 词：细胞因子 川崎病 T淋巴细胞亚群 炎症反应 

分 类 号：R725.4[医药卫生—儿科]