摘要
目的 探讨可溶性细胞间黏附分子-1（sICAM-1）在静脉注射丙种球蛋白（IVIG）无反应型川崎病（KD）患儿中表达的特点和意义。方法 选取使用IVIG治疗的KD患儿271例，其中IVIG敏感型252例，IVIG无反应型19例；发生冠脉扩张的患儿78例；同年龄健康对照组36例。ELISA法检测血浆sICAM-1水平，同时实验室检测全血WBC、中性粒细胞、CRP、血清谷草转氨酶、血钠和血钾水平。结果 IVIG治疗前，敏感型及无反应型患儿sICAM-1水平均明显高于对照组（P〈0.05），且无反应型患儿sICAM-1水平亦高于敏感型患儿（P〈0.05）；IVIG治疗后24~48 h，无反应型患儿sICAM-1水平高于敏感型患儿（P〈0.05）；IVIG治疗前，IVIG敏感合并冠脉扩张患儿中sICAM-1水平明显高于IVIG敏感合并无冠脉扩张患儿（P〈0.05），IVIG无反应合并冠脉扩张患儿sICAM-1水平亦明显高于IVIG无反应合并无冠脉扩张患儿（P〈0.05）；无反应型患儿sICAM-1水平与治疗前后WBC水平变化均呈正相关（分别r=0.7562、0.8435，均P〈0.01），与治疗后CRP水平变化亦呈正相关（r=0.8936，P〈0.01）。结论 高水平的sICAM-1表达可望作为预测KD患儿对IVIG反应情况及发生冠脉扩张的一项危险因素。
Objective To investigate the expression of soluble intercellular adhesion molecule-1 （sICAM-1） and itd significance in children with intravenous immunoglobulin （IVIG）-resistant Kawasaki disease （KD）. Methods A total of 271 children with KD who received IVIG treatment （including 252 IVIG-sensitive cases and 19 IVIG-resistant cases） were selected in the study; 78 of the 271 children had coronary artery dilation. Thirty-six age-matched healthy children were selected as the control group. Plasma sICAM-1 levels were measured using enzyme-linked immunosorbent assay. White blood cell count （WBC）, neutrophil count, C-relative protein （CRP）, aspartate aminotransferase（AST）, serum sodium, and serum potassium were measured by laboratory tests. Results Before IVIG treatment, the IVIG-sensitive cases and IVIG-resistant cases had significantly higher sICAM-1 levels than the control group （P〈0.05）, and the IVIG-resistant cases had significantly higher sICAM-1 levels than the IVIG-sensitive cases （P〈0.05）. After 24-48 hours of IVIG treatment, the IVIG-resistant cases had significantly higher sICAM-1 levels than the IVIG-sensitive cases （P〈0.05）. Before IVIG treatment, among the IVIG-sensitive cases, the sICAM-1 level was significantly higher in those with coronary artery dilation than in those without coronary artery dilation （P〈0.05）; among the IVIG-resistant cases, the sICAM-1 level was significantly higher in those with coronary artery dilation than in those without coronary artery dilation （P〈0.05）. In the IVIG-resistant cases, sICAM-1 level was positively correlated with WBC （before and after treatment） （r=0.7562, P〈0.01; r=0.8435, P〈0.01） and CRP （after treatment） （r=0.8936, P〈0.01）. Conclusions High sICAM-1 level may be used as a risk factor for resistance to IVIG and coronary artery dilation in children with KD.
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2013年第12期1109-1112,共4页
Chinese Journal of Contemporary Pediatrics
作者简介
刘凡，女，硕士，主治医师。[通信作者]尹薇，主任医师。
