P选择素和血管内皮生长因子测定在川崎病诊疗中的价值

目的探讨川崎病（KD）患儿外周血P选择素（CD62P）和血管内皮生长因子（VEGF）浓度的变化,评价其在KD诊断和预后判断中的价值。方法以36例KD患儿为研究对象,17例非KD发热儿童为非KD发热组,17名健康体检儿童为健康对照组进行研究。同时KD患儿根据心脏彩超评定标准分为冠状动脉扩张组（6例）和冠状动脉未扩张组（30例）。KD患儿在应用阿斯匹林和大剂量静脉滴注丙种球蛋白（IVIG）治疗前及治疗后5～7 d分别采集外周静脉血,用流式细胞仪测定CD62P,用酶联免疫吸附法（ELISA）测定VEGF。结果 KD患儿治疗前后的CD62P水平均较非KD发热组和健康对照组明显升高（分别P〈0.05和〈0.01）,VEGF水平显著高于非KD发热组和健康对照组（均P〈0.01）。VEGF和CD62P在冠状动脉扩张组与未扩张组比较,差异无统计学意义（P〉0.05）。川崎病治疗前VEGF和CD62P成正相关（r=0.49,P〈0.01）。结论 CD62P和VEGF参与了KD的发病过程,可作为疾病诊断的参考指标。KD患儿中CD62P和VEGF成正相关,它们共同参与了KD的炎症反应。

The Value of Measuring CD62P and VEGF Levels in Kawasaki Disease

Objective To explore the change of CD62P and VEGF in KD children.It is further to evaluate the diagnostic and prognostic value of CD62P and VEGF in KD.Methods Thirty-six children with KD were objects of study.Seventeen febrile children with infection formed the febrile groups.Seventeen healthy children formed the health control groups.Refered to echocardiogram diagnostic standard,samples from children with KD were divided into two groups： coronary artery dilatation groups（n= 6） and coronary artery normal groups（n=30）.Vessel blood was collected before aspirin and IVIG treatment and 5~7 days after treatment in KD.CD62P were detected with whole blood flow cytometry.VEGF were detected with enzyme linked immunosorbent assay（ELISA）.Results Children with KD in both period（before treatment and after treatment） had significant higher levels of CD62P than that in the febrile groups（P0.05）and healthy control subjects（P0.01）.Children with KD in both period had significant higher levels of serum VEGF than those in the febrile groups（P0.01） and healthy control groups（P0.01）.When CD62P and VEGF in KD before treatment were measured,there was no deference between coronary artery dilatation groups and coronary artery normal groups（P0.05）.CD62P was correlated with VEGF（r=0.49,P0.01）.Conclusion CD62P and VEGF may involve in the pathogenesis in KD and can be indexes in KD.CD62P is correlated with VEGF in children with KD.CD62P and VEGF both involve in KD inflammation.