摘要目的 观测川崎病(KD)患儿单核细胞趋化蛋白1(MCP-1)的血浆浓度及外周血单个核细胞(PBMC)中MCP-1 mRNA表达的变化,并分析其与KD及冠状动脉损害的关系.方法 采用ELISA方法及荧光定量PCR技术测定56例KD患儿急性期与缓解期血浆MCP-1浓度及PBMC中MCP-1 mRNA表达变化,并与60例非感染患儿、66例非KD发热患儿进行比较.结果 KD患儿急性期血浆MCP-1水平[(409.55±97.42)pg/ml]与PBMC中MCP-1 mRNA表达水平(1.97±0.77)明显高于非感染对照组与发热组;KD患儿缓解期血浆MCP-1水平[(301.64±71.55)pg/ml]与PBMC中MCP-1 mRNA表达水平(1.31±0.39)明显高于非感染对照组,与发热组相比差异无统计学意义;KD组中冠状动脉损害者血浆MCP-1水平和PBMC中MCP-1 mRNA表达水平在急性期与缓解期均明显高于无冠状动脉损害者.结论 MCP-1在川崎病患儿体内持续增高,可能参与了促使单个核细胞聚集于冠状动脉局部的趋化作用过程,有可能作为判断KD病情活动状态及冠状动脉损害的免疫学指标之一.

abstractsObjective Kawasaki disease(KD)is a febrile illness of childhood.The etiology of KD remains unknown. Multiple theories exist,including an infectious etiology and an immunological abnormality.Cardiac involvement ranges from myocarditis and pericarditis in the acute stage to the development of coronary artery aneurysms later in the coupe.The present study aimed to explore the effect of monocyte chemotactic protein-1(MCP-1)in Kawasaki disease and its relationship with damage to the coronary arteries during the development of KD.Methods Plasma MCP-1 concentrations were measured by enzyme-linked immunosorbent assay(EUSA),and MCP-1 mRNA expression in peripheral blood mononuclear cells(PBMC)was measured by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR)in comparison of three groups:56 patients with KD,60 age-matched patients with noninfectious diseases,and 66 age-matched febrile patients with various diseases.Results Plasma MCP-1 concentration and MCP-1 mRNA expression in PBMC of patients with active KD [(409.55±97.42)pg/ml] and(1.97±0.77)were higher than those of control group.Plasma MCP-1 levels and MCP-1 mRNA expression of inactive KD group[(301.64±71.55)pg/ml]and(1.31±0.39)were significantly higher than those of non-infectious diseases patients.There was a marked inerease in patients with inactive KD than those of non-infective patients,but there were no significant differences between inactive KD and febrile patients.Plasma MCP-1 levels and MCP-1 mRNA expression were markedly increased in KD patients with coronary artery lesions than those in patients without coronary artery lesions.Conclusion Plasma MCP-1 concentration and MCP-1 mRNA expression in PBMC were significantly increased in patients with KD,and they were higher in KD with coronary artery lesions.It indicates that MCP-1 may be a useful parameter for monitoring disease activity in patients with KD.