中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2012年
2期
158-160
,共3页
川崎病%内皮微粒%流式细胞术%冠状动脉损伤
川崎病%內皮微粒%流式細胞術%冠狀動脈損傷
천기병%내피미립%류식세포술%관상동맥손상
Kawasaki disease%Endothelial microparticle%Flow cytometry%Coronary artery lesions
目的 通过观察川崎病患儿血浆内皮微粒(endothelial microparticle,EMP)水平的变化,确定EMP水平变化与川崎病冠状动脉损伤的关系,探讨EMP测定在早期诊断冠状动脉损伤中的价值.方法 30例川崎病患儿均符合日本川崎病研究委员会第4次修订的诊断标准,其中24例为完全型川崎病,6例为不完全型川崎病,并按病程分为急性期、亚急性期、恢复期.根据超声心动图将川崎病组又分为冠状动脉损伤组(6例)和冠状动脉无损伤组(24例).以10例发热伴有皮疹的患儿及10例健康儿童为发热对照组和正常对照组.采用流式细胞术检测血浆中CD31+/CD42b- EMP水平.结果 川崎病患儿急性期血浆EMP水平[(8.18±2.29)％]明显高于恢复期[(2.77±0.85)％]和正常对照组[(1.34±0.38)％](P＜0.01)；亚急性期血浆EMP水平[(5.93±1.05)％]明显高于恢复期和正常对照组(P＜0.01)；发热对照组血浆EMP水平[(3.66±1.16)％]高于正常对照组(P＜0.05)；急性期川崎病患儿中冠状动脉损伤组血浆EMP水平高于冠状动脉无损伤组,差异有统计学意义(P＜0.01).结论 血浆EMP的检测分析有助于川崎病的早期诊断及冠状动脉损伤的早期发现.
目的 通過觀察川崎病患兒血漿內皮微粒(endothelial microparticle,EMP)水平的變化,確定EMP水平變化與川崎病冠狀動脈損傷的關繫,探討EMP測定在早期診斷冠狀動脈損傷中的價值.方法 30例川崎病患兒均符閤日本川崎病研究委員會第4次脩訂的診斷標準,其中24例為完全型川崎病,6例為不完全型川崎病,併按病程分為急性期、亞急性期、恢複期.根據超聲心動圖將川崎病組又分為冠狀動脈損傷組(6例)和冠狀動脈無損傷組(24例).以10例髮熱伴有皮疹的患兒及10例健康兒童為髮熱對照組和正常對照組.採用流式細胞術檢測血漿中CD31+/CD42b- EMP水平.結果 川崎病患兒急性期血漿EMP水平[(8.18±2.29)％]明顯高于恢複期[(2.77±0.85)％]和正常對照組[(1.34±0.38)％](P＜0.01)；亞急性期血漿EMP水平[(5.93±1.05)％]明顯高于恢複期和正常對照組(P＜0.01)；髮熱對照組血漿EMP水平[(3.66±1.16)％]高于正常對照組(P＜0.05)；急性期川崎病患兒中冠狀動脈損傷組血漿EMP水平高于冠狀動脈無損傷組,差異有統計學意義(P＜0.01).結論 血漿EMP的檢測分析有助于川崎病的早期診斷及冠狀動脈損傷的早期髮現.
목적 통과관찰천기병환인혈장내피미립(endothelial microparticle,EMP)수평적변화,학정EMP수평변화여천기병관상동맥손상적관계,탐토EMP측정재조기진단관상동맥손상중적개치.방법 30례천기병환인균부합일본천기병연구위원회제4차수정적진단표준,기중24례위완전형천기병,6례위불완전형천기병,병안병정분위급성기、아급성기、회복기.근거초성심동도장천기병조우분위관상동맥손상조(6례)화관상동맥무손상조(24례).이10례발열반유피진적환인급10례건강인동위발열대조조화정상대조조.채용류식세포술검측혈장중CD31+/CD42b- EMP수평.결과 천기병환인급성기혈장EMP수평[(8.18±2.29)％]명현고우회복기[(2.77±0.85)％]화정상대조조[(1.34±0.38)％](P＜0.01)；아급성기혈장EMP수평[(5.93±1.05)％]명현고우회복기화정상대조조(P＜0.01)；발열대조조혈장EMP수평[(3.66±1.16)％]고우정상대조조(P＜0.05)；급성기천기병환인중관상동맥손상조혈장EMP수평고우관상동맥무손상조,차이유통계학의의(P＜0.01).결론 혈장EMP적검측분석유조우천기병적조기진단급관상동맥손상적조기발현.
Objective To study the changes of plasma endothelial microparticles (EMP) in children with Kawasaki disease (KD) and its relation to coronary artery lesions (CAL).Methods The participants in this study were 30 children with KD (24 children with typical KD and 6 cases with incomplete KD).All KD patients met the diagnostic criteria established by the Japanese Kawasaki Disease Research Committee.According to the course of KD,3 phases were divided:the acute phase,the subacute phase and the convalescent phase.We evaluated the presence of CAL using two-dimensional echocardiographic examination,and then the KD children were divided into two groups,including 24 children without CAL and 6 children with CAL.Ten children with fever and rash and 10 healthy children were studied as control.The levels of CD31+/CD42b- EMP were measured by flow cytometry.Results The level of EMP was significantly higher in the acute phase [ (8.18 ± 2.29) ％ ] than those either in the convalescent phase [ (2.77 ± 0.85 ) ％ ] of KD or the healthy children [ ( 1.34 ± 0.38 ) ％ ] (P ＜ 0.01 ).The level of EMP was also significantly higher in the subacute phase [ (5.93 ± 1.05 )％ ] than those either in the convalescent phase of KD or the healthy children (P ＜0.01 ).The level of EMP was higher in the children with fever [ (3.66 ± 1.16) ％ ] than that in the healthy children ( P ＜ 0.05 ).Furthermore,the level of EMP during the acute phase was also higher in KD patients with CAL than in those without CAL(P ＜0.01 ).Conclusion The measurement of EMP may be useful for the early diagnosis of KD and the identification of CAL.
