氧化型低密度脂蛋白与川崎病冠状动脉损害的相关性

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摘要目的：观察川崎病（KD）患儿血浆氧化型低密度脂蛋白（oxLDL）的表达，分析其与KD冠状动脉损害的相关性。方法：将确诊为KD的60例患儿作为KD组，再将其根据二维超声心动图分为冠状动脉损害组（CAL组）和冠状动脉正常组（NCAL组），分别于急性期和亚急性期采集静脉血。同时收集本院住院的发热患儿和门诊体检的正常健康儿童各20例为发热对照组和正常对照组，并采集静脉血。采用双抗体夹心固相酶联免疫吸附法（ELISA）检测血浆oxLDL浓度。结果：KD患儿无论急性期、亚急性期血浆oxLDL含量均高于对照组，2组差异有统计学意义（均P＜0.05）。丙种球蛋白使用后血浆oxLDL水平有下降趋势，但与急性期相比差异无统计学意义（P＞0.05）。CAL组患儿血浆oxLDL水平明显高于NCAL组（P＜0.05）。结论：oxLDL在KD冠状动脉持续损害中具有重要作用，大剂量丙种球蛋白不能完全缓解KD内皮功能障碍。

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	何跃娥
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	项如莲

关键词 ：川崎病, 冠状动脉损害, 氧化型低密度脂蛋白, 丙种球蛋白类

Abstract：Objective: To observe the expression of plasma oxidized low-density lipoprotein (oxLDL) in children with Kawasaki disease and to analyze the correlation of oxLDL with coronary artery lesions. Methods: Sixty cases diagnosed as Kawasaki disease (KD group) were divided into coronary artery lesion group (CAL group) and non-coronary artery lesion group (NCAL group) based on two-dimensional echocardiography. The venous blood was collected in acute stage and sub-acute stage (one week after the use of intravenous immunoglobulin). Twenty healthy controls and twenty fever control were enrolled into the study, and their venous blood was collected. Oxidized low- density liprproteins (oxLDL) was measured with enzyme linked immunosorbent assay (ELISA). Results: Compared with normal control group and fever control group, plasma oxLDL levels were higher in children with Kawasaki disease, whether acute or sub-acute, the difference was statistically significant (P<0.05). After the use of intravenous immunoglobulin plasma oxLDL levels have decreased, but the difference was not statistically significant compared with the acute stage (P>0.05). Compared with non-coronary artery lesion group, plasma oxLDL levels were significantly higher in coronary artery lesion group (P<0.05). Conclusion: Oxidized LDL plays an important role in the coronary artery sustained damage, the high-dose intravenous immunoglobulin can not completely relieve endothelial dysfunction in Kawasaki disease.

Key words： Kawasaki disease coronary artery lesion oxidized low-density liprproteins gamma-globulins

收稿日期: 2016-06-27

基金资助:浙江省自然科学基金资助项目（LQ16H020008）；浙江省医药卫生科技项目（2017KY465）。

通讯作者: 项如莲，主任医师，教授，Email：13676742659@163.com。

作者简介: 何跃娥（1979-），女，浙江丽水人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I1/19

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