摘要
目的探讨川崎病(KD)血管损伤机制。方法应用酶联免疫吸附实验(ELISA)和双抗体夹心法检测66例KD患儿[KD组,其中冠状动脉病变(CAL)组18例,非冠状动脉病变(NCAL)组48例]、30例健康儿童(健康对照组)、35例肺炎、扁桃腺炎、肠炎等其他疾病患儿(其他疾病对照组)D-二聚体和纤维蛋白原含量,并同时检测C-反应蛋白(CRP)和血小板计数(plt)。分别于急性期(发病10d内)和恢复期(病程5～7周)进行二维彩色超声心动图检查,选择大动脉短轴切面探测左、右冠状动脉及左冠状动脉前降支内径,剑下四腔心探测左冠状动脉回旋支及右冠状动脉末端内径。冠状动脉损害诊断标准为小于3岁者大于2.5mm,4～9岁者大于3mm,10～14岁者大于3.5mm。结果KD组D-二聚体和纤维蛋白原含量高于健康对照组,差异有统计学意义(P<0.01);合并冠状动脉病变(CAL)组D-二聚体和纤维蛋白原含量高于无冠状动脉病变(NCAL)组,差异有统计学意义(P<0.01);KD组CRP、plt含量高于健康对照组,差异有统计学意义(P<0.05),与其他疾病对照组无明显差异;KD组D-二聚体和纤维蛋白原含量明显高于其他疾病对照组,差异均有统计学意义(P<0.01),与plt计数无明显相关性(P>0.05)。结论D-二聚体和纤维蛋白原含量与KD合并CAL有密切关系,两者升高反映了KD患儿存在明显的高凝状态和血栓形成倾向,对预测CAL具有一定的临床价值。
Objective To identify the direct relationship between plasma D-dimer and FIB and Kawasaki disease patients who with coronary artery lesion complication. Methods The levels of plasma D-dimer and FIB were measured by enzyme linked immunosorbent assay and CRP and plt were investigated among 66 patients and 30 healthy children. Patients were divided into coronary artery lesion group and non coronary artery lesion group. Results The levels of plasma D-dimer and FIB were significantly higher than those in the healthy group （P〈0.01）. Plasma D-dimer and FIB in group CAL were significantly higher than those in group NCAL （P〈0.01）. CRP in group CAL was higher than that in the healthy group （P〈0.05）. Conclusion D-dimer and FIB are related to KD. The high levels of D-dimer and FIB are related to the severity of vascular damage in KD. It may be a sensitive predictor of coronary artery lesion.
出处
《重庆医学》
CAS
CSCD
北大核心
2010年第4期417-419,共3页
Chongqing medicine
基金
广西壮族自治区卫生厅计划课题资助项目(Z2009024)
