目的 探讨川崎病（Kawasaki disease, KD）急性期患儿的血清氧化磷脂（oxidized phospholipids, OxPLs）和内皮一氧化氮合酶（endothelial nitric oxide synthase, eNOS）水平的变化，分析血清OxPLs和eNOS水平与冠状动脉病变（coronary artery lesion, CAL）的相关性，并探讨其临床意义。 方法 前瞻性选择95例急性期KD患儿作为KD组，根据是否合并CAL分为CAL亚组和非冠状动脉病变（non-coronary artery lesion, NCAL）亚组；另外选取同期30例仅下呼吸道感染发热患儿作为发热组，30例健康体检儿童作为健康对照组。比较各组一般资料及血清OxPLs、eNOS等实验室指标的差异，分析血清OxPLs和eNOS的相关性。 结果 KD组OxPLs水平高于发热组及健康对照组（P<0.05），eNOS水平低于发热组及健康对照组（P<0.05）。KD患儿治疗后较治疗前血清OxPLs下降，血清eNOS上升（P<0.05）。CAL亚组血清OxPLs高于NCAL亚组（P<0.05），血清eNOS水平低于NCAL亚组（P<0.05）。KD组患儿OxPLs与eNOS水平呈负相关（rs=-0.353, P<0.05）。 结论 KD急性期血清OxPLs、eNOS参与了CAL发展，可成为预测KD患儿发生CAL的生物标志物。
Abstract
Objective To investigate the changes in the serum levels of oxidized phospholipids (OxPLs) and endothelial nitric oxide synthase (eNOS) and their association with coronary artery disease (CAL) in children in the acute stage of Kawasaki disease (KD), as well as the clinical significance of OxPLs and eNOS. Methods A prospective study was conducted on 95 children in the acute stage of KD (KD group). According to the presence of absence of CAL, the KD group was further divided into a CAL subgroup and a non-CAL (NCAL) subgroup. Thirty children with fever due to lower respiratory tract infection were enrolled as the fever group. Thirty healthy children who underwent physical examination were enrolled as the healthy control group. The above groups were compared in terms of general information and serum levels of OxPLs, eNOS and other laboratory indexes, and the correlation between OxPLs level and eNOS level was analyzed. Results The KD group had a significantly higher level of OxPLs and a significantly lower level of eNOS compared with the fever group and the healthy control group (P<0.05). After treatment, the children with KD had a significantly decreased OxPLs level and a significantly increased eNOS level (P<0.05). Compared with the NCAL subgroup, the CAL subgroup had a significantly higher level of OxPLs and a significantly lower level of eNOS (P<0.05). Among the children of KD, the level of OxPLs was negatively correlated with that of eNOS (rs=-0.353, P<0.05). Conclusions Serum OxPLs and eNOS in the acute stage of KD may be involved in the development of CAL in children with KD, and therefore, they may be used as the biomarkers to predict CAL in these children.
关键词
川崎病 /
冠状动脉病变 /
血清型氧化磷脂 /
内皮一氧化氮合酶 /
儿童
Key words
Kawasaki disease /
Coronary artery lesion /
Serum oxidized phospholipid /
Endothelial nitric oxide synthase /
Child
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参考文献
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基金
长沙市科技计划项目（No.kq1801091）。
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