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目的观察川崎病(KD)患儿血清IL-6、IL-8水平变化,探讨其与冠状动脉损伤(CAL)的关系。方法采用前瞻性实验研究方法 ,研究对象为2003年10月-2005年12月本院住院的46例KD患儿(KD组),平均年龄2.21岁(5个月~8.75岁),根据超声结果将患儿分为CAL组(18例)和无CAL组(28例)。测定所有患儿血清IL-6、IL-8水平,16例健康体检儿童(健康对照组)也进行血清IL-6、IL-8检测。结果 1.KD组患儿治疗前血清IL-6、IL-8水平分别为52.39(24.39~134.46)ng.L-1和68.64(52.88~230.18)ng.L-1,均显著高于健康对照组[7.17(4.25~10.29)ng.L-1和10.34(9.60~11.57)ng.L-1],2组比较差异均有统计学意义(Pa<0.05),但二者无相关性(r=-0.166,P>0.1)。2.CAL组和无CAL组患儿IL-6水平分别为37.50(24.08~139.34)ng.L-1、31.21(19.67~87.90)ng.L-1,2组比较差异有统计学意义(P<0.05);CAL组和无CAL组患儿IL-8水平分别为47.18(16.98~109.72)ng.L-1和46.34(4.40~89.86)ng.L-1,2组比较差异无统计学意义(P>0.05);5例冠状动脉持续扩张患儿IL-6、IL-8水平在恢复期持续增高。结论 KD患儿血清IL-6、IL-8水平的增高与免疫性血管炎有关。IL-6对CAL的作用可能较IL-8更为重要,对高IL-6水平的患儿应注意有无CAL的存在。持续性IL-6、IL-8高水平表达,可能与临床部分KD患儿晚发性CAL有关。
Objective To observe the changes of serum IL-6 and IL-8 levels in children with Kawasaki disease (KD) and to explore their relationship with coronary artery injury (CAL). Methods A prospective experimental study was conducted in 46 children with KD (KD group) hospitalized in our hospital from October 2003 to December 2005 with an average age of 2.21 years (ranged from 5 months to 8.75 years). According to the results of ultrasound The children were divided into CAL group (18 cases) and no CAL group (28 cases). Serum levels of IL-6 and IL-8 were measured in all children. Serum IL-6 and IL-8 were also detected in 16 healthy children (healthy control group). The levels of IL-6 and IL-8 in children with KD before treatment were 52.39 (24.39-134.46) ng.L-1 and 68.64 (52.88-230.18) ng.L-1, respectively, which were significantly higher than those in healthy controls The difference between the two groups was statistically significant (P <0.05), but there was no significant difference between the two groups (r = 0.17 (4.25-10.29) ng.L-1 and 10.34 (9.60-11.57) ng.L- = -0.166, P> 0.1). IL-6 levels in children with and without CAL were 37.50 (24.08 ~ 139.34) ng.L-1,31.21 (19.67 ~ 87.90) ng.L-1 and 2, respectively.The difference was statistically significant (P <0.05). The levels of IL-8 in children with and without CAL were 47.18 (16.98-109.72) ng.L-1 and 46.34 (4.40-89.86) ng.L-1 and 2, respectively, with no significant difference (P> 0.05). The levels of IL-6 and IL-8 in 5 patients with continuous coronary artery dilatation continued to increase during recovery. Conclusion The serum levels of IL-6 and IL-8 in children with KD are associated with immune vasculitis. The effect of IL-6 on CAL may be more important than that of IL-8, and the presence of CAL should be noticed in children with high IL-6 level. Sustained high levels of IL-6 and IL-8 may be related to late-onset CAL in children with KD.