抗中性粒细胞抗体在川崎病诊断中的价值

Value of anti-neutrophil cytoplasmic antibody in diagnosis of Kawasaki disease

摘要:

目的：探讨抗中性粒细胞抗体（ANCA)在川崎病诊断中的价值。方法：检测30例典型川崎病患儿和16 例不完全川崎病患儿急性期、恢复期血清ANCA，并随机选取25例健康儿童作为对照组。同时对川崎病患儿急性期行超声心动图(UCG)检查。结果：川崎病患儿急性期血清ANCA阳性率为65%，其中不完全川崎病组和典型川崎病组血清ANCA阳性率分别为69％、63％，均明显高于对照组(P＜0.01）。川崎病患儿恢复期血清ANCA阳性率显著低于急性期（33％ vs 65％，P＜0.05）。川崎病患儿急性期血清ANCA阳性率显著高于UCG的阳性检出率(P＜0.01)。ANCA阳性患儿冠脉病变发生率明显高于ANCA阴性患儿（43％ vs 13％，P＜0.05)。结论：血清ANCA可以作为一项早期诊断川崎病的参考指标和发生冠脉损害的一项实验室预警指标。

Abstract:

OBJECTIVE: To study the value of anti-neutrophil cytoplasmic antibody (ANCA) in diagnosis of Kawasaki disease (KD). METHODS: Serum ANCA was detected in 30 children with typical Kawasaki disease (TKD) and in 16 with incomplete Kawasaki disease (IKD) in the acute and the recovery phases respectively. Twenty-five healthy children were randomly selected as a control group. An ultrasonic cardiography (UCG) was performed on children with KD in the acute phase. RESULTS: The mean positive rate of serum ANCA in the acute phase in KD children was 65%, with 69% in IKD children and 63% in TKD children, which were obviously higher than that in the control group (P＜0.01). The positive rate of serum ANCA in the recovery phase in KD children was significantly lower than that in the acute phase (33％ vs 65％, P＜0.05). The positive rate of serum ANCA in the acute phase in children with KD was significantly higher than that detected by UCG (P＜0.01). The incidence rate of coronary artery lesions in children with positive ANCA was obviously higher than that in children with negative ANCA (43％ vs 13％; P＜0.05). CONCLUSIONS: Serum ANCA may be used as a reference index for early diagnosis of KD and secondary coronary artery lesions in children.