川崎病患儿尿白三烯E4测定及其 临床意义分析

目的    观察尿白三烯（LTs）E4（LTE4）在儿童典型川崎病（KD）中的变化，探讨是否可以将LTs作为KD后的监测指标。方法    东南大学附属盐城医院儿科2007年10月至2010年9月收治68例完全性KD患儿，采用竞争性酶联免疫吸附技术检测其在治疗前后尿LTE4水平，55名正常儿童尿LTE4作为对照组，同时对KD急性期患儿行心脏彩超检查，分为有冠状动脉损害组（8例）和无冠状动脉损害组（60例）。结果    KD 患儿治疗前尿LTE4均高于正常对照组，差异有统计学意义（P < 0.01）；恢复期与正常对照组比较，差异无统计学意义（P > 0.05）；KD合并冠状动脉损害组尿LTE4明显高于无冠状动脉损害组，差异有统计学意义（P < 0.01）；所有KD患儿治疗前后比较，LTE4均明显降低（P <0.01）。结论    KD尤其是合并冠状动脉损害的患儿LTs水平明显增高，尿LTE4可作为KD后临床监测指标，可以考虑通过早期应用LTs受体拮抗剂干预来达到预防合并冠状动脉病变发生、促进冠状动脉损伤修复的目的。

Clinical significance of urinary leukotriene E4 detection in children with Kawasaki disease.

Objective    To investigate whether leukotriene can be used as KD monitoring index. . Methods    Urinary leukotriene  E4 （LTE4）level of 68 children with typical KD was detected by enzyme-linked immunosorbent assay（ELISA） before and after treatment，and the Urinary LTE4 level of 55 healthy children was detected by the same methods， and then was a mutual comparison made. Meanwhile ultrasonographic examination was made in KD children. According to the results of ultrasonographic examination， all the 68 KD children were divided into two groups： KD with coronary artery damage in one group（n=8），KD without the damage in the other group（n=60）. Results    The Urinary LTE4 level of KD group was significantly higher than that of healthy control group （P < 0.01）， but after treatment， there were no significant difference between two groups（P > 0.05）. The urinary LTE4 level of KD with coronary artery damage was significantly higher than that of KD without（P < 0.01）. The urinary LTE4 level of all KD before treatment was significantly higher than that after treatment  （P < 0.01）. Conclusion    In KD patients especially those with coronary artery damage，LTs level is much higher. Urinary leukotriene E4 level can be used as KD clinical monitoring index.It can be considered that through the early intervention by leukotriene receptor antagonist  we may prevent KD coronary artery pathological changes from happening and  so promote the repair of coronary artery damage.