川崎病儿童载脂蛋白和脂蛋白及血脂水平变化的临床研究

目的]研究川崎病(Kawasaki disease ,KD)患儿血清脂类(载脂蛋白、脂蛋白、血脂)在病程各临床分期中的变化情况. 方法]120例川崎病患儿在疾病的不同临床分期及120名对照组儿童均进行血清脂类测定. 结果]川崎病组血清脂类无年龄与性别差异,病程中TG、ApoB100、ApoE比对照组高(P＜0.01),TC、HDL-C、ApoAI比对照组低(P＜0.01),LDL-C、Lpa与正常儿童相比差异无显著性(P均＞0.05).急性期明显下降的项目有:TC、HDL-C、ApoAI、Lpa;除了ApoE,其余项目亚急性期均比急性期高.TC、HDL-C在亚急性期已接近正常水平,TG、LDL-C、Lpa、ApoAI、ApoB100在恢复期时基本达到正常水平.ApoE在KD病程中各期差异无显著性(P＞0.05),但水平始终高于对照组(P＜0.01). 结论]KD患儿血清脂类除ApoE外,在临床各期均有不同程度变化,但基本上是一过性的,到恢复期时基本上接近正常水平.KD患儿在疾病过程中存在的血脂代谢紊乱对其可能有长远的影响,临床应重视对血脂结果的分析,及早干预.

Changes in serum levels of lipids, lipoproteins and apolipoproteins composition in patients with Kawasaki disease

To investigate the changes in the serum levels of lipids, lipoproteins and apolipoproteins composition in patients during the acute to convalescence phages of Kawasaki disease. Serum came from 120 case of Kawasaki disease that was divided into three phases and from 120 case of control group. Serum lipids (TC, TG), lipoproteins (HDL C, LDL C, Lpa) and apolipoproteins (ApoA I, ApoB 100 , ApoE), in four groups were detected and compared. No significant difference was observed in the levels of serum lipids, lipoproteins and apolipoproteins either age or sex in patients of Kawasaki disease. The levels of TG, ApoB 100 , ApoE were significantly higher in Kawasaki disease than in control( P <0.01), the contents of TC, HDL C and ApoAI were remarkable lower in Kawasaki disease( P <0.01). No significant difference was observed in the levels of LDL C and Lpa ( P =0.096,0.578) between Kawasaki disease and control group. TC, HDL C, Lpa and ApoAI decreased during the acute phase of Kawasaki disease. The levels of TC, TG, HDL C, LDL C, Lpa, ApoA I and ApoB 100 in subacute phase were higher than in the acute phase. Levels of TC, HDL C subacute phase and levels of TG, LDL C, Lpa, ApoA I and ApoB 100 in the convalescence phase returned to the normal range. No change was observed in the level of ApoE during acute to convalescence phases of Kawasaki disease( P >0.05), and level of ApoE in Kawasaki disease was higher than that in control group( P <0.01).Conclusions] The changes of lipid, lipoproteins and apolipoproteins levels associated with Kawasaki disease were temporary except ApoE,most of the levels of lipids, lipoproteins and apolipoproteins composition approached normal values during the subsequent convalescence phase.