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目的 探讨P选择素 (P selectin ,PS)、E选择素 (E selectin ,ES)在小儿川崎病血管损伤中的作用机制 ,寻找其与冠状动脉 (简称冠脉 )损伤之间直接关系的依据。方法 应用酶联免疫吸附实验 (ELISA)双抗体夹心法、放免法检测 36例川崎病 (KD)患儿、2 0例发热疾病患儿、30例健康对照组儿童的PS、ES、血栓素 (TXB2 )、6酮前列腺素F1α(6 KPGF1α) ,并将KD患儿分为急性期、亚急性期、恢复期 ;有冠脉损伤 (CAL)组与无冠脉损伤 (NCAL)组 ,根据初始应用静脉丙种球蛋白 (IVIG) 4 8小时是否热退分为IVIG有效组与IVIG无效组。结果 KD患儿组的PS、ES急性期 [(2 11± 2 8、186± 14 )ng/ml ]、亚急性期 [(2 38± 2 7、15 1± 13)ng/ml]和恢复期 [(198± 2 1、10 0± 9)ng/ml]均高于健康对照组 [(10 2±36、72± 10 )ng/ml],差异有显著性 (P <0 0 1) ;治疗后PS仍维持较高水平 ,但IVIG有效组PS、ES下降与急性期相比差异有显著性 (P <0 0 1) ;CAL组PS、ES[(2 81± 78、2 10± 5 2 )ng/ml]水平明显高于NCAL组 [(2 17± 15、10 8± 10 )ng/ml,P <0 0 1],IVIG有效组PS、ES水平治疗后 2周比治疗后 1周降低 ,差异有显著性 (P <0 0 1) ,IVIG无效组PS水平治疗后 2周仍高于治疗后 1周 ,但差异无显著性 (P >0 0 5 ) ;治疗?
Objective To investigate the mechanism of P selectin (PS) and E selectin (ES) in vascular injury of children with Kawasaki disease, and to find out the direct relationship between P selectin (PS) and E (select coronary artery) injury. Methods Thirty-six children with KD, 20 children with fever and 30 healthy controls were enrolled in this study. The levels of PS, ES, thromboxane TXB2 and 6 KPGF1α. The patients with KD were divided into acute, subacute and convalescent phases. The patients with coronary artery injury (CAL) and without coronary artery injury (NCAL) Intravenous intravenous gamma globulin (IVIG) 48 hours thermal re-divided into IVIG effective group and IVIG invalid group. Results In the KD group, the acute phase of PS, ES were (2 11 ± 2 8,186 ± 14) ng / ml], subacute phase [(2 38 ± 2 7,15 1 ± 13) ng / ml] (198 ± 2 1,10 ± 9) ng / ml] were significantly higher than those in healthy controls [(102 ± 36,72 ± 10) ng / ml] (P <0.01); PS, ES [(2 81 ± 78,210 ±) in CAL group were significantly higher than those in acute phase 5 2) ng / ml] was significantly higher than that of NCAL group [(2 17 ± 15, 108 ± 10) ng / ml, P 0 01) 1 week, the difference was significant (P <0.01). In the IVIG ineffective group, the PS level was still higher than that of the control group at 1 week after treatment, but the difference was not significant (P> 0.05)