川崎病患儿内皮素1和肌钙蛋白1水平动态变化的研究

目的探讨川崎病（kawasaki disease，KD）患儿急性期后内皮素1（ET-1）和心肌肌钙蛋白I（cTnI）变化的临床意义。方法本院60例川崎病患儿中合并冠状动脉病变者12例，未合并冠状动脉病变者48例，分别测定川崎病患儿及30例健康儿童血浆内皮素1、血清肌钙蛋白I水平，分析病例组急性期和恢复期患儿血浆ET-1与血清cTnI变化，与健康儿童进行对照。结果合并冠状动脉病变（CAL）组急性期ET-1、cTnl分别为（90．19±3．43）ng／L,（1．35±0．14）μg／L，其恢复期ET-1、cTnl分别为（89．09±2．44）ng／L、（1．12±0．11）μg／L，两组比较差异均无统计学意义（P〉0．05）；无冠状动脉损伤（NCAL）组急性期ET-1、cTnI浓度值分别为（64.494±4．78）ng／L、（0．62±0．02）μg／L，恢复期ET-1、cTnI浓度值分别为（50．474±4．49）ng／L、（0．07±0．05）μg／L，两组比较差异均有统计学意义（P〈0．01）。川崎病患儿急性期和恢复期血浆ET-1与血清cTnI浓度呈正相关（r=0．93，0．96，P〈0．01）。结论川崎病合并冠状动脉病变患儿血浆内皮素1水平与血清肌钙蛋白I水平相关，可作为川崎病合并冠状动脉病变的早期风险监测指标。

The study on the changes of endothelin-1 and troponin-1 levels in kawasaki disease

Objective To discuss the clinical significance of the changes of endothelin-1 and troponin-1 levels in kawasaki disease after acute stage. Methods 60 patients of kawasaki disease in which 12 cases of patient were complicated with coronary artery disease and 48 cases of patient who were not complicated with coronary artery disease were enrolled this study. Blood plasma endothelin-1 and serum cardiac troponin I were determined in kawasaki disease acute phase and recovery phase and 30 healthy children. Results Acute phase ET-1 and cTnI (90.19±3.43)ng/L, (1.35±0.14)μg/L] and recovery phase ET-1 and cTnI (89.09±2.44)ng/L, (1.12±0.11)μg/L ] in coronary artery lesions of (CAL) group had no significant difference（P＞0.05）. The concentration values of ET-1, cTnI in no coronary artery lesions (NCAL) group of acute phase (64.49±4.78)ng/L,(0.62±0.02)μg/L were different with convalescent phase (50.47±4.49)ng/L,(0.07±0.05)μg/L. There were significant difference between the the two phases (P＜0.01). Plasma endothelin-1 and serum troponin I concentrations were positively correlated in acute phase of Kawasaki disease in children (r＝0.93,0.96,P＜0.01). Conclusions Plasma endothelin-1 and serum cardiac troponin I test for the diagnosis of Kawasaki disease with coronary artery disease may be early indicators of risk monitoring, they are valuable indexes in diagnosis and treatment of Kawasaki disease.