川崎病患儿白细胞介素-15水平变化的临床意义

目的探讨白细胞介素-15（IL-15）在川崎病（KD）发病机制中的作用及其应用价值。方法选择2004年10月～2006年1月本院住院的30例KD患儿作为研究对象,采用酶联免疫吸附法（ELISA）检测KD患儿急性期和恢复期血清IL-15水平,同期检测30例下呼吸道感染发热期和20例正常健康儿童作为对照。结果急性期KD患儿血清IL-15水平明显高于健康对照组,二者比较有显著性差异（q=25.64P〈0.01）;恢复期KD患儿血清IL-15水平下降,但仍较健康对照组增高,二者比较有显著性差异（q=4.00P〈0.01）;KD患儿血清IL-15水平急性期与恢复期比较有显著性差异（t=14.87P〈0.01）。KD患儿急性期和恢复期血清IL-15水平均明显高于下呼吸道感染患儿急性期和恢复期,有显著性差异（急性期t=6.28P〈0.01;恢复期t=4.34P〈0.01）;急性期随KD患儿IL-15水平升高,ESR也相应升高,二者呈显著正相关（r=0.371P=0.044）,但与外周血WBC计数、CRP和血清清蛋白（ALB）变化无明显相关性;与IgG存在正相关性（r=0.372P=0.043）。结论IL-15参与KD的病理生理过程,IL-15可能促使免疫细胞大量激活,进而介导组织免疫病理损伤。IL-15水平变化反映KD的病情状况,可能为早期诊断提供一定线索。

Clinical Significance of Changes of Interleukin-15 Levels in Children with Kawasaki Disease

Objective To explore the role of interleukin-15(Il-15)in pathogenesis of Kawasaki disease(KD)and its potential cli-nical value.Methods Thirty patients with KD were selected in Xinhua hospital from Oct.2004 to Jan.2006.The serum concentration of IL-15 was measured by enzyme linked immunosorbent assay(ELISA)in acute stage and convalescent stage of KD,and 30 children with low respiratory inflection and 20 healthy children were studied as controls.Results Serum IL-15 level in acute KD was significantly higher than that in normal control,and the two sides were remarkably different in statistics(q=25.64 P<0.01).Serum IL-15 level in convalescent KD was low,but still higher than that in normal control,and these 2 sides were also remarkably different in statistics(q=4.00 P<0.01).The difference between acute KD and convalescent KD were remarkably(t=14.87 P<0.01).The serum IL-15 levels in acute KD and convalescent KD were significantly higher than that in low respiratory infection at the acute stage and the convalescent stage,which were remarkably different in statistics(acute stage:t=6.28 P<0.01;convalescent stage:t=4.34 P<0.01).Serum IL-15 level in acute KD was a positive correlation with erythrocyte sedimentation rate(ESR)(r=0.371 P=0.044)and immunoglobulin G(IgG)(r=0.372 P=0.043),but was not related to white blood cell(WBC)counts,C-reactive protein(CRP)and albumin(ALB).Conclusions IL-15 may take part in the pathophysiologic process of KD;Serum IL-15 may induce immunocytes to activate and mediate the immunopathologic impairment of KD.Besides,the change of serum IL-15 level reflects pathogenetic condition,so it may provide clinical clues for the inchoate diagnosis of KD.