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目的:探讨川崎病(KD)患儿静脉注射用丙种球蛋白(IVIG)治疗前后血清肿瘤坏死因子-α(TNF-α)水平变化及其意义。方法:治疗组选择本院确诊KD患儿34例,分为冠状动脉损伤组14例和无冠状动脉损伤组20例;正常对照组选择年龄相仿的门诊体检健康儿童l5例。采用酶联免疫吸附法检测KD患儿经IVIG治疗前后及对照组血清TNF-α水平。结果:KD患儿治疗前急性期血清TNF-α水平明显高于正常对照组(P<0.01);与无冠状动脉损伤组比较,冠状动脉损伤组血清TNF-α水平升高更明显(P<0.05)。经IVIG治疗后KD患儿恢复期血清TNF-α水平明显降低(P<0.01)。结论:血清TNF-α水平在KD患儿急性期、尤其有冠状动脉损伤时明显升高;血清TNF-α可能参与KD冠状动脉损伤的病理过程。
Objective: To investigate the changes of serum tumor necrosis factor-α (TNF-α) levels in children with Kawasaki disease (KD) before and after intravenous administration of gamma globulin (IVIG). Methods: In the treatment group, 34 children with KD diagnosed in our hospital were selected and divided into coronary injury group (n = 14) and coronary artery injury group (n = 20). In the control group, 15 outpatients with similar ages were selected as healthy children. Serum levels of TNF-α in children with KD before and after IVIG treatment and control group were detected by enzyme-linked immunosorbent assay. Results: The levels of serum TNF-α in acute KD children before treatment were significantly higher than those in normal control group (P <0.01). Compared with those without coronary artery injury, serum TNF-α level increased significantly in coronary artery injury group (P < 0.05). After IVIG treatment, the level of serum TNF-α in convalescent children with KD was significantly lower (P <0.01). CONCLUSION: Serum TNF-α levels are significantly increased in children with acute KD, especially with coronary artery injury. Serum TNF-α may be involved in the pathogenesis of KD coronary artery injury.