基质金属蛋白酶及其抑制剂在川崎病患儿冠脉损害中的临床意义

目的研究川崎病（KD）患儿血清基质金属蛋白酶3（MMP-3）、基质金属蛋白酶抑制剂1（TIMP-1）的表达水平,探讨其在KD冠脉损害中的临床意义。方法研究组为30例川崎病患儿,冠脉损害（CAL）组15例,冠脉正常（NCAL）组15例,分别收集急性期、恢复期外周血制备血清。对照组为30例年龄相仿的正常健康儿童。用酶联免疫吸附实验（ELISA）测定各组患儿血清中MMP-3、TIMP-1的水平。结果川崎病CAL组血清MMP-3、MMP-3/TIMP-1和NCAL组相比明显升高（P〈0.05）;CAL组血清TIMP-1水平较NCAL组明显降低（P〈0.01）。KD急性期MMP-3、TIMP-1、MMP-3/TIMP-1与恢复期和正常对照组相比较均明显升高（P〈0.01）。结论川崎病CAL组血清MMP-3和NCAL组相比明显升高,提示MMP-3可以作为预测与早期诊断CAL的客观指标。KD急性期MMP-3、TIMP-1、MMP-3/TIMP-1水平明显高于恢复期和对照组,提示MMP-3、TIMP-1、MMP-3/TIMP-1可作为早期诊断川崎病的一个客观生化指标。

The significance of MMPs and TIMPS with coronary artery lesions in Kawasaki disease

Objective To explore the expression of MMP-3 and TIMP-1 in Kawasaki disease and discuss their significance in the coronary artery lesion(CAL)with KD.Methods The serum was collected from 30 KD children(15 patients with coronary arterial lesions,group CAL;and 15 patients with no coronary arterial lesions,group NCAL.) Serum collection with KD in the acute phase and convalescence phase.Control group:30 normal children with the similar age.The levels of MMP-3,TIMP-1,were detected by Enzyme-linked immunosorbent assay(ELISA) in serum.Results MMP-3 and MMP-3/TIMP-1 of group CAL are compared with group NCAL,were significantly higher than that in group NCAL(P<0.05).TIMP-1 of group NCAL is compared with group CAL,is significantly higher than that in group CAL(P<0.01);acute phase and convalescence phase MMP-3、TIMP-1and the ratio of MMP-3/TIMP-1 level are compared with Normal control group are significantly higher than that in group normal(P<0.01).Conclusion MMP-3 of group CAL is significiantly higher than group NCAL,Therefore,the measurement of serum MMP-3 might be of important clinical value in the prediction and the early diagnosis of KD with coronary artery lesion.In acute stage serum MMP-3 and TIMP-1 levels and the ration of MMP-3/TIMP-1 were higher in patients with KD than that in convalescent stage and control group;suggesting that these data are important objective markers with diagnosis KD in early stage.