CAJ | 학술논문

目的：探讨Th17细胞在儿童丙种球蛋白耐药性川崎病发病机制中的作用。方法选择2013年5月~2014年5月本院诊断为川崎病的患儿100例作为研究对象，根据是否存在耐药性分为丙种球蛋白耐药组和非丙种球蛋白耐药组，选择30例正常儿童作为健康对照组，收集研究对象外周血4~5 ml，提取外周血单个核细胞，采用流式细胞术检测Th17细胞，采用荧光定量PCR检测IL-23P19与RORrt基因mRNA表达量。结果丙种球蛋白耐药组外周血PBMC中Th17细胞占CD4+细胞百分率明显高于非丙种球蛋白耐药组、健康对照组，且非丙种球蛋白耐药组高于健康对照组，差异有统计学意义(P<0.05)；丙种球蛋白耐药组及非丙种球蛋白耐药组RORrt基因表达量高于健康对照组(P<0.05)；非丙种球蛋白耐药组IL-23P19基因mRNA表达量与健康对照组比较差异无统计学意义(P>0.05)。结论 Th17细胞表达与丙种球蛋白耐药型川崎病发病具有相关性，这为丙种球蛋白耐药型川崎病的诊治及预后提供新的研究途径，有利于减少川崎病患儿心血管损伤的后遗症，保护儿童身心健康，具有较大的社会效益和经济效益。
목적：탐토Th17세포재인동병충구단백내약성천기병발병궤제중적작용。방법선택2013년5월~2014년5월본원진단위천기병적환인100례작위연구대상，근거시부존재내약성분위병충구단백내약조화비병충구단백내약조，선택30례정상인동작위건강대조조，수집연구대상외주혈4~5 ml，제취외주혈단개핵세포，채용류식세포술검측Th17세포，채용형광정량PCR검측IL-23P19여RORrt기인mRNA표체량。결과병충구단백내약조외주혈PBMC중Th17세포점CD4+세포백분솔명현고우비병충구단백내약조、건강대조조，차비병충구단백내약조고우건강대조조，차이유통계학의의(P<0.05)；병충구단백내약조급비병충구단백내약조RORrt기인표체량고우건강대조조(P<0.05)；비병충구단백내약조IL-23P19기인mRNA표체량여건강대조조비교차이무통계학의의(P>0.05)。결론 Th17세포표체여병충구단백내약형천기병발병구유상관성，저위병충구단백내약형천기병적진치급예후제공신적연구도경，유리우감소천기병환인심혈관손상적후유증，보호인동신심건강，구유교대적사회효익화경제효익。
Objective To investigate effect of Th17 cells expressing in the pathogenesis of gammaglobulin-resistant Kawasaki disease. Methods 100 cases of children with Kawasaki disease in our hospital from May 2013 to May 2014 were selected as the research objects.According to whether the presence or absence of immunoglobulin resistance,100 patients were divided into gammaglobulin-resistant group and non-gammaglobulin-resistant group.30 normal children were selected as healthy control group.All patients were collected 4-5 ml peripheral blood and peripheral blood mononuclear cells were extrated.Th17 cells were detected by flow cytometry,IL-23P19 and RORrt gene were detected by mRNA fluorescence quantitative PCR expression. Results Percent of PBMC Th17 in CD4+cells of gammaglobulin-resistant group was significantly higher than that of non-gammaglobulin-resistant group and healthy control group re-spectively,percent of PBMC Th17 in CD4+ cells of non-gammaglobulin-resistant group was significantly higher than that of healthy control group,with statistical difference(P<0.05).RORrt gene expression of gammaglobulin-resistant group and non-gammaglobulin-resistant group was higher than that of healthy control group respectively (P<0.05).IL-23P19 mRNA expression had no statistical difference between non-gammaglobulin-resistant group and healthy control group (P>0.05). Conclusion Th17 cells expression and gammaglobulin-resistant Kawasaki disease was relevant.This provides a new approach for diagnosis and prognosis of immunoglobulin resistant Kawasaki disease,reduces cardiovascular injury sequelae,protects children’s physical and mental health,has a great social benefit,economic benefit.