川崎病患儿血清脂联素水平的变化

Serum adiponectin levels in children with Kawasaki disease

摘要:

目的 探讨川崎病(Kawasaki disease, KD)患儿血清脂联素的变化及意义.方法 选取KD 患儿45 例,其中冠状动脉损伤(CAL)患儿18 例,未合并CAL 患儿27 例;另选取健康儿童20 例作为对照组.采用ELISA 法检测血清脂联素水平,全自动生化测定仪检测血脂四项,包括甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C).结果 合并CAL 与未合并CAL 组急性期、亚急性期、恢复期血清脂联素水平均低于正常对照组(P<0.01);急性期与亚急性期其水平均低于恢复期(P<0.01).在急性期与恢复期,CAL 组血清脂联素水平显著高于未合并CAL 组(P<0.05).合并CAL 与未合并CAL 组血清TC、HDL、LDL 均较正常对照组降低(P<0.05).KD 患儿血清脂联素水平与TC、TG、CRP 水平及CAL 的发生呈明显正相关,r 分别为0.31、0.30、0.34、0.35,均P<0.05.结论 KD 患儿存在血脂紊乱及低脂联素水平;血清脂联素水平降低可能是全身炎症反应的结果;血清脂联素增加与CAL 的发生关系密切.

Abstract:

Objective To explore the change in serum adiponectin levels and its significance in children with Kawasaki disease (KD). Methods Forty-five KD patients were enrolled in this study, including 18 with coronary artery lesions (CAL group) and 27 without coronary artery lesions (NCAL group). Twenty healthy children were recruited to the control group. Enzyme-linked immunosorbent assay was used to measure serum adiponectin levels, and an automatic biochemical analyzer was used to measure the levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Results The serum adiponectin levels in the CAL and NCAL groups were significantly lower than in the control group during the acute phase, subacute phase, and recovery phase (P<0.01), with lower levels observed during the acute phase and subacute phase (P<0.01). Compared with the NCAL group, the CAL group had significantly higher serum levels of adiponectin during the acute phase and recovery phase (P<0.05). The levels of TC, HDL, and LDL in the NCAL and CAL groups were significantly lower than in the control group (P<0.05). The levels of serum adiponectin in KD patients were positively correlated with the levels of TC, TG, and C-reactive protein and the occurrence of CAL (r=0.31, 0.30, 0.34, and 0.35, respectively; P<0.05). Conclusions Children with KD have metabolic disorders of blood lipids and reduced serum adiponectin levels. Reduced serum adiponectin levels may be the result of systemic inflammation, while increased adiponectin levels may be closely associated with the occurrence of CAL.