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目的:探讨川崎病(KD)患儿不同时间点外周血单个核细胞(PBMC)共刺激分子4-1BB的表达及意义。方法:选择30例KD住院患儿为研究对象,30名健康体检儿童作为对照组。KD患儿分2个时间点采集外周血标本:(1)发病初未用丙种球蛋白(IVIG)时,患儿体温39℃~40℃,呈稽留或弛张热型(急性期);(2)足量IVIG治疗后体温正常1周以上(缓解期)。采用反转录-聚合酶链式反应(RT-PCR)法检测KD患儿不同时间点PBMC共刺激分子4-1BB mRNA的表达,并分析其与血清C反应蛋白(CRP)的关系。结果:(1)对照组儿童和KD患儿PBMC均有4-1BB mRNA的表达。(2)急性期KD患儿PBMC 4-1BB mRNA的表达水平明显升高,与对照组及缓解期KD患儿比较差异均有统计学意义(P均<0.05);缓解期KD患儿与对照组比较差异有统计学意义(P<0.05)。(3)KD患儿4-1BB mRNA的表达水平与血清CRP呈正相关(r=0.723,P<0.05)。结论:共刺激分子4-1BB可能参与了KD的发病,可作为监测病情的免疫学指标。
Objective: To investigate the expression of 4-1BB in peripheral blood mononuclear cells (PBMCs) in children with Kawasaki disease (KD) at different time points. Methods: Thirty children with KD were selected as the research object and 30 healthy children as the control group. Peripheral blood samples were collected from children with KD at two time points: (1) Children with hypothermia (acute phase) with or without warm-type fever (39 ℃ ~ 40 ℃) without IVIG; 2) Adequate body temperature after IVIG treatment for more than 1 week (remission). The expression of 4-1BB mRNA of PBMC costimulatory molecules at different time points was detected by reverse transcription-polymerase chain reaction (RT-PCR) and its relationship with serum C-reactive protein (CRP) was analyzed. Results: (1) The expression of 4-1BB mRNA in control group children and children with KD were all significantly higher than those in control group. (2) The expression of 4-1BB mRNA in PBMC of children with acute KD was significantly higher than that of control and KD children (all P <0.05) The difference was statistically significant (P <0.05). (3) The expression of 4-1BB mRNA in children with KD was positively correlated with serum CRP (r = 0.723, P <0.05). Conclusion: Co-stimulatory molecule 4-1BB may be involved in the pathogenesis of KD, which can be used as an immunological indicator to monitor the disease.