MMP-1、IL-6及VEGF与川崎病患儿冠状动脉损伤的关系

目的观察川崎病患儿血清基质金属蛋白酶1(MMP-1)、白细胞介素6(IL-6)及血管内皮生长因子(VEGF)的表达水平,探讨其在小儿川崎病冠状动脉损伤(CAL)中的作用。方法选择2011年1月至2013年12月宝鸡市人民医院儿科就诊的川崎病患儿(川崎病组)54例,其中无冠状动脉损伤(NCAL)组24例,合并冠状动脉损伤(CAL)组30例,另以年龄相仿的20例健康体检儿童为健康对照组。分别检测患儿及健康儿童血清MMP-1、IL-6及VEGF水平。结果川崎病患儿急性期血清MMP-1为(19.2±4.1)μg/L、IL-6为(47.7±9.6)ng/L及VEGF为(214.5±15.8)ng/L。缓解期,血清MMP-1(13.1±3.5)μg/L、IL-6(14.4±5.5)ng/L及VEGF为(123.2±16.7)ng/L水平明显高于健康对照组(P<0.05),且CAL组较NCAL组升高更为显著。川崎病组急性期血清MMP-1及IL-6与外周血白细胞计数呈正相关(r=0.69,P<0.05;r=0.78,P<0.01),而VEGF水平与血清白蛋白呈负相关(r=-0.63,P<0.01)。结论 MMP-1、IL-6及VEGF在川崎病患儿,特别在伴CAL时表达明显升高,可能参与川崎病血管损伤尤其是CAL的病理生理过程。

The Relationship of MMP-1, IL-6 and VEGF with Coronary Artery Lesions in Children with Kawasaki Disease

Objective To observe the serum levels of MMP-1, IL-6 and VEGF in patients with Kawasaki disease（KD） ,and to discuss their potential roles in the pathogenesis of coronary artery lesions（CAL）. Methods Fifty-four patients with KD,including 24 patients without CAL（ NCAL group） and 30 patients with CAL （ CAL group）, as well as age-matched 20 healthy controls （ control group） from Baoji City People＇ s Hospital during Jan. 2011 and Dec. 2013 were included in the study. Serum levels of MMP-1 ,IL-6 and VEGF were detected respectively. Results In children with KD at acute phase the serum MMP 1 was （ 19.2 ±4.1 ） μg/L, IL-6 was （47.7 ±9.6） ng/L and VEGF was （214.5 ±15.8） ng/L;at remission phase,MMP 1 was （ 13.1± 3.5 ） μg/L, serum IL-6 was （ 14.4 ±5.5 ） ng/L and VEGF was （ 123.2 ±16.7 ） ng/L, which were obviously higher than that of the healthy controls （ P 〈 0.05 ） , and with the increase in the CAL group was more significant than the NCAL group. There was a significantly positive correlation between the serum levels of MMP-1 and IL-6 and the circulating leucocytes counts at the acute phase of KD （ r = 0. 69, P 〈 0.05 ; r = 0. 78, P 〈 0.01 ） ,and there was a significantly negative correlation between the serum levels of VEGF and albumin （r = - 0.63 ,P 〈 0.01 ）. Conclusion The levels of MMP-1, IL-6 and VEGF increase notably at the acute phase of KD, especially in KD patients with CAL,indicating that they may be involved in the pathogenesis of vascular lesion especially CAL of KD.