川崎病患儿血清中基质金属蛋白酶-9及其组织抑制物-1的变化

目的评价基质金属蛋白酶-9(MMP-9)及其组织抑制物-1(TIMP-1)在川崎病(KD)发病机制中的作用。方法采用酶联免疫吸附法(ELISA)检测33例KD患儿治疗前后血清MMP-9及TIMP-1的含量,并设置无热、发热对照组;同时检测KD患儿外周血中性粒细胞计数、C反应蛋白(CRP)等指标。结果KD组患儿急性期MMP-9血清水平较对照组升高,合并冠脉损害(CAL)者尤甚,治疗后降至正常;MMP-9的升高与外周血中性粒细胞计数、CRP呈正相关;KD患儿无论是否合并CAL,其急性期TIMP-1血清水平均高于对照组,治疗后虽有所下降,仍较对照组高;MMP-9/TIMP-1比值在KD组急性期与对照组差异无统计学意义,治疗后较无热对照组降低,与发热对照组差异无统计学意义。结论MMP-9作为一种损害因素参与了川崎病的病理生理过程,而TIMP-1可抑制其作用;MMP-9的水平可反映KD的严重程度。

Serum levels of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in children with Kawasaki disease

Objective To investigate the serum levels of matrix metalloproteinase-9(MMP-9)and tissue inhibitor of metalloproteinase-1(TIMP-1)for the evaluation of their roles in the pathogenesis of Kawasaki disease(KD).Methods Serum levels of MMP-9 and TIMP-1 were detected by ELISA in 33 patients with KD(six cases associated with coronary artery lesion(CAL)),10 febrile patients with infection and 10 afebrile children without infection enrolled as control,respectively.Peripheral neutrophil and C reactive protein(CRP)were determined simultaneously in three groups.Results The serum levels of MMP-9 and TIMP-1 were significantly higher in the patients with KD than those in either febrile or afebrile groups.Serum level of MMP-9 in patients with CAL was higher than that in cases without CAL,while no diffe-rence in the level of TIMP-1 was observed between patients with or without CAL.After treatment of IVGG plus Aspirin,serum level of MMP-9 decreased to normal range and TIMP-1 level maintained slightly higher in the patients with KD.The increase of MMP-9 correlated positively with the increase of peripheral neutrophil and CRP.Serum TIMP-1 level was higher in the KD patients either with CAL or without CAL.There was no significant difference in the ratio of MMP-9/TIMP-1 between KD group and control groups.The ratio of MMP-9/TIMP-1 after treatment in the KD group was lower than that in the afebrile group,and without difference with the febrile group.Conclusions MMP-9 is involved in the pathophysiological process of KD as a damage factor that could be inhibited by TIMP-1.The serum levels of MMP-9 may reflect the seve-rity of KD,such as KD associated with CAL.