摘要
目的探讨抗血管内皮细胞抗体(AECA)检测在川崎病(KD)早期诊断及体液免疫状况方面的临床意义。方法检测58例KD急性期患儿和43例对照组(其中普通发热对照23例,健康对照20例)儿童的血清AECA-IgG、免疫球蛋白IgG、IgA、IgM和补体C3、C4,计算各组AECA的阳性率,进而分别比较AECA阳性KD组、AECA阴性KD组与对照组的上述指标的浓度差异。结果①KD患儿AECA-IgG的阳性率为39.7%,明显高于健康对照组的5.0%(P<0.01),也高于发热对照组的17.4%,但无统计学差异(P>0.05);②AECA阳性组与AECA阴性组IgG、IgM、IgA、C3浓度均分别明显高于发热对照组和正常对照组(P<0.05),C4水平只有AECA阳性组明显高于发热对照组和健康对照组(P<0.05),但AECA阳性组与阴性组间上述指标差异无统计学意义(P>0.05)。结论血清抗内皮细胞抗体在川崎病患儿中有较高的阳性率,具有一定的早期辅助诊断价值。川崎病急性期存在着明显的体液免疫异常,IgA介导的体液免疫可能在其中扮演着重要角色。
Objective To explore the clinical significance of serous anti-endothelial cell antibodies （AECA） in Kawasaki disease （KD） in aspects of early diagnostic value and humoral immunologic condition. Method Serous AECA-IgG were determined in 58 samples with KD at acute stage as well as 43 samples including 23 with ordinary febricity and 20 healthy children as control groups. Concentrations of immunoglobulin G（IgG）, IgA, IgM, compliment3 （C3） and C4 were compared among AECA-IgG groups and control groups. Result AECA-IgG positive rate in KD group was significant higher than ordinary febricity group （39.7% vs 17.4%, P=0.055） and health group （39.7% vs 5.0%, P〈 0.01）. There was a significant difference for the concentrations of IgG, IgA, IgM, C3 and C4 in AECA-IgG positive group compared with ordinary febricity group and health group （P〈0.05）. Such difference was also found in AECA-IgG negative group except the concentration of C4 while there was no statistical difference between AECA-IgG positive group and AECA-IgG negative group （P〉0.05）. Conclusion Based on relatively high positive rate for IgG AECA in children with KD, there is limited early diagnostic value for serous AECA detection. Children with KD have evident humoral immunologic derangement, in which humoral immunity mediated by IgA may play an important role.
出处
《热带医学杂志》
CAS
2008年第12期1230-1232,1244,共4页
Journal of Tropical Medicine
关键词
川崎病
抗血管内皮细胞抗体
免疫球蛋白
补体
Kawasaki disease
anti-endothelial cell antibodies
immunoglobulin
compliment
