川崎病患儿治疗前后血清脂源性细胞因子的变化及意义

Changes in serum levels of adipokine after treatment in children with Kawasaki disease

摘要:

目的 检测急性期川崎病患儿静脉注射丙种球蛋白（IVIG）治疗前后血清中脂源性细胞因子Omentin-1和Chemerin浓度变化及意义。方法 选取2015年1月至2019年4月确诊为川崎病患儿60例为研究对象，同时选取40例健康儿童和40例急性感染性疾病患儿分别作为健康对照组和感染对照组。根据是否对IVIG治疗敏感将川崎病患儿分为IVIG敏感组（n=51）和IVIG不敏感组（n=9）；根据是否合并冠状动脉损害（CAL）将川崎病患儿分为合并CAL组（n=13）和不合并CAL组（n=47）。ELISA法检测川崎病患儿IVIG治疗前后及两对照组儿童血清Omentin-1和Chemerin水平。结果 川崎病患儿血清Omentin-1和Chemerin水平均明显高于健康对照组和感染对照组（P < 0.05）。经过48 h治疗后，IVIG敏感组患儿血清Chemerin水平较治疗前明显降低（P < 0.05），血清Omentin-1水平在IVIG敏感组患儿治疗前后比较差异无统计学意义（P > 0.05）。治疗前，IVIG不敏感组患儿血清Chemerin水平明显高于IVIG敏感组（P < 0.05）；合并CAL组血清Chemerin水平明显高于不合并CAL组；而血清Omentin-1水平在IVIG敏感与不敏感组间及合并CAL与不合并CAL组间比较差异均无统计学意义（P > 0.05）。结论 川崎病患儿血清中高表达的Chemerin和Omentin-1可能参与川崎病的发生和发展；Chemerin可能参与川崎病所致CAL过程，且血清Chemerin水平可能成为临床预测IVIG敏感性的新监测指标。

Abstract:

Objective To study the changes in the serum levels of Chemerin and Omentin-1 in children with Kawasaki disease (KD) in the acute stage after intravenous immunoglobulin (IVIG) treatment and related clinical significance. Methods A total of 60 children who were diagnosed with KD from January 2015 to April 2019 were enrolled as subjects. Forty healthy children and 40 children with acute infectious diseases were enrolled as the healthy control group and the infection control group respectively. According to the sensitivity to IVIG treatment, the children with KD were divided into an IVIG sensitive group with 51 children and a non-IVIG sensitive group with 9 children. According to the presence or absence of coronary artery lesion, the children with KD were divided into a CAL group with 13 children and a non-CAL group with 47 children. ELISA was used to measure the serum levels of Omentin-1 and Chemerin before and after the treatment. Results The children with KD had significantly higher serum levels of Chemerin and Omentin-1 than the healthy control and infection control groups before treatment (P < 0.05). After 48 hours of treatment, the IVIG sensitive group had a significant reduction in the serum level of Chemerin (P < 0.05), while there was no significant change in the serum level of Omentin-1 after treatment (P > 0.05). Before treatment, the non-IVIG sensitive group had a significantly higher serum level of Chemerin than the IVIG sensitive group (P < 0.05), and the CAL group had a significantly higher serum level of Chemerin than the non-CAL group, while there was no significant difference in the serum level of Omentin-1 between the IVIG sensitive and non-IVIG sensitive groups, as well as between the CAL and non-CAL groups (P > 0.05). Conclusions High serum levels of Chemerin and Omentin-1 may play an important role in the development and progression of KD. Chemerin may be involved in the development of CAL in children with KD. The serum level of Chemerin may be used as a new index for predicting the sensitivity to IVIG treatment.