可溶性黏附分子在丙种球蛋白无反应型川崎病中的表达

刘凡; 丁艳; 尹薇

doi:10.7499/j.issn.1008-8830.2013.12.018

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中国当代儿科杂志 ›› 2013, Vol. 15 ›› Issue (12) : 1109-1112. DOI: 10.7499/j.issn.1008-8830.2013.12.018

论著·临床研究

可溶性黏附分子在丙种球蛋白无反应型川崎病中的表达

刘凡, 丁艳, 尹薇

作者信息 +

Expression of sICAM-1 in children with intravenous immunoglobulin-resistant Kawasaki disease

LIU Fan, DING Yan, YIN Wei

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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。

Abstract

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.

导出引用

刘凡, 丁艳, 尹薇. 可溶性黏附分子在丙种球蛋白无反应型川崎病中的表达[J]. 中国当代儿科杂志. 2013, 15(12): 1109-1112 https://doi.org/10.7499/j.issn.1008-8830.2013.12.018

LIU Fan, DING Yan, YIN Wei. Expression of sICAM-1 in children with intravenous immunoglobulin-resistant Kawasaki disease[J]. Chinese Journal of Contemporary Pediatrics. 2013, 15(12): 1109-1112 https://doi.org/10.7499/j.issn.1008-8830.2013.12.018

参考文献

[1] 李焰, 王献民, 柳颐龄, 石坤, 杨艳峰, 郭永宏. 川崎病患儿并发冠状动脉病变的危险因素分析[J]. 中国当代儿科杂志, 2012, 14 (12): 938-941.
[2] 段超, 杜忠东, 王玉, 贾立群. 川崎病冠脉瘤患儿远期血管内皮功能的研究[J]. 中国当代儿科杂志, 2011, 13(5): 373-376.
[3] 方宏, 李雪迎, 杜军保. 静脉注射丙种球蛋白无反应型川崎病药物治疗Meta分析[J]. 中国实用儿科杂志, 2010, 25(7): 551-556.
[4] 姜波, 吴红, 陈世锋, 吴隆敬. 可溶性细胞间黏附分子-1和可溶性选择素E在自身免疫性风湿病中的表达[J]. 中华风湿病学杂志, 2006, 10(4): 230-232.
[5] Yanangawa H, Sonobe T. Changes in the diagnostic guidelines for Kawasaki disease[M]//Yanagawa H, Nakamuru Y, YashiroM. Epidemiology of Kawasaki disease: a 30-year achievement. Tokyo: Shindan-To-Chiryosha, 2004: 24-32.
[6] Adachi S, Sakaguchi H, Kuwahara T, Uchida Y, Fukao T, Kondo N. High regression rate of coronary aneurysms developed in patients with immune globulin-resistant Kawasaki disease treated with steroid pulse therapy[J]. Tohoku J Exp Med, 2010, 220(4): 285-290.
[7] Uehara R, Belay ED. Epidemiology of Kawasaki disease in Asia, Europe, and the United States[J]. J Epidemiol, 2012, 22(2): 79-85.
[8] Ban JY, Kim SK, Kang SW, Yoon KL, Chung JH. Association between polymorphisms of matrix metalloproteinase 11(MMP-11)and Kawasaki disease in the Korean population[J]. Life Sci, 2010, 86(19-20): 756-759.
[9] 闫辉, 万宏, 杜军保, 陈永红, 李万镇, 刘雪芹, 等. 静脉注射丙种球蛋白无反应型川崎病危险因素及预测分析[J]. 实用儿科临床杂志, 2012, 27(21): 1637-1640.
[10] Sleeper LA, Mccrindle BM, Minich LL, Li JS, Mason W, Colan SD, et al. Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance[J]. J Pediatr, 2011, 158(5): 831-835.
[11] Hwang JY, Lee KY, Rhim JW, Youn YS, Oh JH, Han JW, et al. Assessment of intravenous immunoglobulin non-responders in Kawasaki disease[J]. Arch Dis Child, 2011, 96(11): 1088-1090.
[12] 王敏, 蒋利萍, 李秋, 李欣, 王莉佳, 杨锡强. CD40L、可溶性粘附分子及MMP9在川崎病中的表达及意义[J]. 实用临床免疫学, 2006, 22(9): 867-869.
[13] Loftus IM, Thompson MM. The role of matrix metalloproteinases in vascular disease[J]. Vasc Med, 2002, 7(2): 117-133.
[14] 陈建粮. 细胞间粘附分子Ⅰ表达的调控[J]. 国外医学免疫学分册, 2000, 23: 272-275.
[15] 付劲蓉, 李成荣, 周玉峰. 粘附分子在川崎病血管炎性损伤中的作用机制探讨[J]. 中华儿科杂志, 2002, 40(2): 108-109.
[16] 宋宜慧, 黄熙. 细胞间粘附分子-1与血管生成的研究进展[J]. 免疫学杂志, 2012, 28(6): 530-533.
[17] Nowak-Sliwinska P, van Beijnum JR, van Berkel M, van den Bergh H, Griffioen AW. Vascular regrowth following photodynamic therapy in the chicken embryo chorioallantoic membrane patrycja nowak-sliwinska[J]. Angiogenesis, 2010, 13(4): 281-292.