血清sIL-2RIL-6与hs-CRP水平的测定在川崎病早期诊断中的临床意义

Value of serum soluble interleukin-2R, interleukin-6 and C-reactive protein in the early diagnosis of Kawasaki disease

摘要:

目的：研究表明川崎病(Kawasakidisease,KD)异常的免疫激活可导致免疫性血管炎。该研究的目的在于探讨川崎病患儿血清可溶性白细胞介素2受体(soubleinterleukin-2receptors,sIL-2R)及白细胞介素-6(in-terleukin-6,IL-6)水平在川崎病早期诊断中的临床意义。方法：收集实验组32例川崎病患儿急性期静脉注射丙种球蛋白(intravenousgammaglobulin,IVIG)前、后及对照组20例外周静脉血,ELISA双抗体法测定血清sIL-2R,IL-6含量,同时检测血清超敏C-反应蛋白(high-sensitiveC-reactiveprotein,hs-CRP)含量。结果：川崎病患儿急性期用IVIG前及用IVIG后血清sIL-2R和hs-CRP含量均较正常儿童显著增高(P<0.05);IVIG用前较用后血清sIL-2R和hs-CRP含量同样有显著增高(P<0.05);IVIG前川崎病患儿血清IL-6水平较正常儿童显著增高(P<0.05)。川崎病患儿血清sIL-2R与hs-CRP水平呈正相关(r=0.60,P<0.01);IVIG前血清IL-6与hs-CRP水平呈正相关(r=0.68,P<0.01)。结论：sIL-2R,IL-6与hs-CRP在川崎病血管炎的病理过程中显著激活,血清sIL-2R与IL-6及hs-CRP水平增高有助于川崎病早期诊断,评估患儿免疫状况。

Abstract:

OBJECTIVE: Immunovasculitis is a pathologic process of Kawasaki disease (KD) in the early stage and it is more likely to be resulted from abnormal immunoactivation. It is thus speculated that the serum levels of some cytokines have changed before immunovasculitis occurs, suggesting the cytokines may be useful markers for the early diagnosis of KD. In this study, we measured the serum levels of soluble interleukin-2 receptors (sIL-2R), interleukin-6 (IL-6) and high-sensitive C-reactive protein (hs-CRP) in patients with KD to evaluate the significance of these cytokines in the early diagnosis of KD. METHODS: Serum levels of sIL-2R and IL-6 were measured by rapid one-step sandwich enzyme immunoassay and the serum hs-CRP level was measured by Dade Behring BN ProSpec in 32 KD patients before and after intravenous immunoglobulin (IVIG) therapy. Twenty healthy children were used as the controls. RESULTS: Before IVIG therapy serum levels of sIL-2R (9253.41±2568.38 pg/mL vs 2161.53±696.92 pg/mL; P<0.05), IL-6 (57.19±45.78 ng/mL vs 7.04±1.69 ng/mL; P<0.05) and hs-CRP (117.69 ±42.05 mg/L vs 1.15±0.54 mg/L; P<0.05) in KD patients were significantly higher than those in healthy controls. After IVIG therapy in KD patients serum IL-6 levels returned to normal and sIL-2R and hs-CRP levels decreased significantly but remained significantly higher than controls( P<0.05 ). There was a positive correlation between sIL-2R and hs-CRP levels (r=0.60, P<0.01). IL-6 levels positively correlated with hs-CRP levels in KD patients before IVIG therapy (r=0.68, P<0.01). CONCLUSIONS: sIL-2R, IL-6 and hs-CRP are activated in the development of KD, and they may be of important value in the early diagnosis of KD.