血浆促酰化蛋白、脂联素在川崎病早期诊断中的作用

目的 观察川崎病(KD)急性期血浆促酰化蛋白(ASP)、脂联素(ADPN)、血脂与急相反应蛋白变化关系,探索KD早期诊断的敏感指标和判断冠脉损伤(CAL)的依据。方法 将研究对象分KD急性期组、呼吸道感染伴发热组和正常健康对照组,每组20例 ELISA方法检测血浆ASP、ADPN浓度,比浊法检测血脂等生化指标。结果 1.KD急性期血浆ASP水平明显高于感染组和正常对照组(P=0.000,0.001),而血浆ADPN水平KD组与发热组相比无显著性变化(P>0.05)。2.KD急性期血浆HDL-C、HDL3-C、apoAⅠ浓度明显低于正常对照组(P=0.000,0.000,0.015);apoAⅠ与ASP呈负相关(r=-0.408 P=0.05);其他血脂指标组间比较无显著性差异(P>0.05);3.KD急性期有冠状动脉扩张组血浆ASP浓度明显高于无冠状动脉扩张组(P=0.003),而ADPN和血脂组间比较无显著性差异(P>0.05)。结论 KD急性期存在明显脂质代谢紊乱,ASP可作为KD早期诊断和判断CAL的敏感性实验室指标。

Effect of acylation stimulating protein and adiponectin on early diagnosis of kawasaki disease

Objective To observe the changes of plasma acylation stimulating protein (ASP), adiponectm(ADPN), C-reactive protein and blood lipid levels in children with kawasaki diseasc(KD) and investigate a sensitive index for early diagnosis after KD and the relationship between ASP, ADPN,lipid levels and the coronary artery lesions(CAL) after KD Methods Sixty subjects were detected in this study , including 20 patients during acute phase of KD, 20 patients of acute respiratory infections with high fever, and 20 controls. ELISA technique was administered to determine the plasma ASP and ADPN concentrations. Blood lipid levels were detected by nephelometric methods. Results 1 The levels of plasma ASP were found increasing significantly in KD during acute phase compared with infected group and healthy controls ( P = 0. 000, 0 001 ), and there were no difference between the two groups on adiponectin (P>0.05). 2. In KD group, the plasma levels of apoA I , HDL-C and HDL3-C were significantly lower than those in control group (P<0.05,0 001,0 001, respectively) Besides, the level of plasma ASP showed negative association with apoAI (r= -0 408 P=0 05) 3. There was significant difference between CAL and the patients without CAL during KD on plasma ASP level (P = 0 003) Conclusions There are great disturbances of lipid metabolism in patients with KD during acute phase. The plasma ASP level may be used as a sensitive index to predict the KD injuries and the development of CAL