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目的探讨川崎病(KD)患儿外周血P选择素(CD62P)和血管内皮生长因子(VEGF)浓度的变化,评价其在KD诊断和预后判断中的价值。方法以36例KD患儿为研究对象,17例非KD发热儿童为非KD发热组,17名健康体检儿童为健康对照组进行研究。同时KD患儿根据心脏彩超评定标准分为冠状动脉扩张组(6例)和冠状动脉未扩张组(30例)。KD患儿在应用阿斯匹林和大剂量静脉滴注丙种球蛋白(IVIG)治疗前及治疗后5～7 d分别采集外周静脉血,用流式细胞仪测定CD62P,用酶联免疫吸附法(ELISA)测定VEGF。结果 KD患儿治疗前后的CD62P水平均较非KD发热组和健康对照组明显升高(分别P<0.05和<0.01),VEGF水平显著高于非KD发热组和健康对照组(均P<0.01)。VEGF和CD62P在冠状动脉扩张组与未扩张组比较,差异无统计学意义(P>0.05)。川崎病治疗前VEGF和CD62P成正相关(r=0.49,P<0.01)。结论 CD62P和VEGF参与了KD的发病过程,可作为疾病诊断的参考指标。KD患儿中CD62P和VEGF成正相关,它们共同参与了KD的炎症反应。
Objective To investigate the changes of P-selectin (CD62P) and vascular endothelial growth factor (VEGF) levels in children with Kawasaki disease (KD) and to evaluate their value in the diagnosis and prognosis of KD. Methods Thirty-six children with KD were enrolled. Seventeen children with non-KD fever were non-KD fever group and 17 healthy children were selected as healthy control group. At the same time, children with KD were divided into two groups: coronary dilatation group (6 cases) and non-dilation group (30 cases). Peripheral venous blood was collected from patients with KD before and after treatment with aspirin and IVIG, and from 5 to 7 days after treatment. The levels of CD62P were measured by flow cytometry (FCM) (ELISA) determination of VEGF. Results The levels of CD62P in children with KD before and after treatment were significantly higher than those in non-KD fever group and healthy controls (P <0.05 and <0.01, respectively), and VEGF levels were significantly higher in children with KD than in non-KD fever group and healthy controls ). There was no significant difference in VEGF and CD62P between the two groups (P> 0.05). Kawasaki disease before treatment and CD62P positive correlation (r = 0.49, P <0.01). Conclusions CD62P and VEGF are involved in the pathogenesis of KD and can be used as a reference for disease diagnosis. CD62P is positively correlated with VEGF in children with KD, and they are involved in the inflammatory reaction of KD.