川崎病患儿血浆转化生长因子-β和血管内皮生长因子水平与冠状动脉病变的相关性研究  

Changes in the level of plasma transforming growth factor-βand vascular endothelial growth factor in Kawasaki disease children and the association with coronary arterial lesion

作　　者：邹瑞瑛 张旭[2] 王瑾[1] 范婉钰 郭俊秀 滕懿群[2] ZOU Ruiying;ZHANG Xu;WANG Jin;FAN Wanyu;GUO Junxiu;TENG Yiqun(Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China;Department of Pediatrics,the Second Hospital of Jiaxing(the Second Affiliated Hospital of Jiaxing University),Jiaxing 314000,Zhejiang,China;Graduate School,Bengbu Medical College,Bengbu 233030,Anhui,China)

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]嘉兴市第二医院(嘉兴学院附属第二医院)儿科,浙江嘉兴314000 [3]蚌埠医学院研究生院,安徽蚌埠233030

出　　处：《中国现代医生》2023年第24期4-8,共5页China Modern Doctor

基　　金：浙江省自然科学基金项目(LY18H040014);嘉兴市公益性研究计划项目(2020AY30019)。

摘　　要：目的观察川崎病(Kawasaki disease,KD)患儿血浆转化生长因子-β(transforming growth factor-β,TGF-β)和血管内皮生长因子(vascular endothelial growth factor,VEGF)水平,并探讨其与冠状动脉病变(coronary arterial lesion,CAL)的相关性。方法选取2020年10月至2022年6月在嘉兴市第二医院儿科住院的KD患儿105例,根据心脏彩超检查结果分为CAL组(20例)与无CAL组(85例),同时选取30例健康体检的儿童为对照组。采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测各组血浆TGF-β、VEGF、血管内皮生长因子受体1(vascular endothelial growth factor receptor-1,VEGFR1)水平,绘制受试者操作特征(receiver operating characteristic,ROC)曲线,比较TGF-β、VEGF单独和联合检测在KD并发CAL预测上的差异。结果KD患儿静脉注射丙种球蛋白(intravenous immunoglobulin,IVIG)治疗前血浆TGF-β、VEGF和VEGFR1水平明显高于IVIG治疗后(均P<0.05)和对照组(均P<0.05);IVIG治疗后血浆TGF-β、VEGF和VEGFR1高于对照组(均P<0.05);CAL组TGF-β和VEGF水平明显高于无CAL组(均P<0.05);CAL组和无CAL组的VEGFR1差异无统计学意义(P>0.05)。Spearman直线相关分析结果显示,TGF-β与白细胞、C反应蛋白和红细胞沉降率呈正相关(均P<0.05);VEGF与白细胞、红细胞沉降率和TGF-β呈正相关(均P<0.05),与白蛋白呈负相关(P<0.05)。ROC曲线分析显示TGF-β和VEGF联合检测预测KD并发CAL的曲线下面积(area under the curve,AUC)为0.727,高于TGF-β和VEGF单独检测(均P<0.05)。结论KD患儿TGF-β和VEGF水平均升高,与并发CAL密切相关,TGF-β和VEGF联合检测对KD并发CAL的预测具有重要的临床意义。Objective To observe plasma transforming growth factor-β(TGF-β)and vascular endothelial growth factor(VEGF)levels in Kawasaki disease(KD)children and to explore the association with coronary arterial lesion(CAL).Methods A total of 105 children with KD in Department of Pediatrics,the Second Hospital of Jiaxing were recruited in the present study from October 2020 to June 2022.According to the results of the echocardiogram examination,these KD children were divided into two groups,CAL group(n=20)and non-CAL group(n=85).At the same time,30 healthy children were selected as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detected the plasma levels of TGF-β,VEGF and vascular endothelial growth factor receptor-1(VEGFR1)in KD children and healthy children.The receiver operating characteristic(ROC)curve was used to compare the difference in prediction of CAL between individual and combined detection of TGF-β,VEGF.Results Compared with healthy controls,the plasma levels of TGF-β,VEGF and VEGFR1 were significantly increased in KD children before intravenous immunoglobulin(IVIG)treatment(all P<0.05),and all the items decreased after IVIG treatment(all P<0.05).However,in KD children after IVIG treatment,levels of TGF-β,VEGF and VEGFR1 were significantly higher than those in healthy controls(all P<0.05).Compared with the non-CAL group,the levels of TGF-βand VEGF were significantly higher in the CAL group(all P<0.05).There was no significant difference in the level of VEGFR1 between two groups(P>0.05).Spearman correlation analysis showed the level of TGF-βwas positively correlated with white blood cell count,C-reactive protein and erythrocyte sedimentation rate(all P<0.05).The level of VEGF was positively correlated with white blood cell count,erythrocyte sedimentation rate and TGF-β(all P<0.05),negtively correlated with albumin(P<0.05).The ROC curve result showed that area under the curve(AUC)of combined detection of TGF-β,VEGF in prediction of CAL were 0.727,which was higher than individual de

关 键 词：川崎病 转化生长因子-Β 内皮生长因子 冠状动脉病变 

分 类 号：R725.4[医药卫生—儿科]