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目的探讨川崎病(KD)急性期细胞因子及T细胞功能的变化。方法2003年1月至2006年10月在长春市儿童医院内科住院的KD患儿共39例,用ELISA方法测定急性期血浆肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)、γ干扰素(γ-IFN)含量及外周血白细胞计数(WBC)、C反应蛋白(CRP);用流式细胞仪测定6例确诊为KD患儿急性期血浆CD3、CD4、CD8百分数。结果KD患儿急性期血浆肿瘤坏死因子α、白细胞介素-1β和γ干扰素水平分别(11.69±3.01)ng/L、(89.25±26.28)ng/L和(31.18±15.34)ng/L,较对照组明显增高(P<0.005、<0.001和<0.05);肿瘤坏死因子α、白细胞介素-1β与末梢血白细胞总数呈明显正相关(rIL-1β=0.887、rTNF-α=0.875)与C-反应蛋白也呈正相关(rIL-1β=0.643、rTNF-α=0.736);急性期T淋巴细胞CD4百分含量增高(30.6±8.96)、CD8百分含量减少(23.3±6.25)、CD4/CD8比值明显增高(1.3±0.06);左冠状动脉大小与γ-IFN含量,前降支大小与TNF-α、IL-1β、γ-IFN含量具有明显直线关系。结论川崎病急性期存在T淋巴细胞调控网络失衡。了解细胞因子在KD发病中的作用,对于KD的治疗有重要意义。
Objective To investigate the changes of cytokines and T cells in acute Kawasaki disease (KD). Methods Thirty-nine KD children admitted to Changchun Children’s Hospital from January 2003 to October 2006 were enrolled in this study. Serum tumor necrosis factor-α (TNF-α), interleukin-1β (IL- 1β, γ-IFN and WBC and C-reactive protein (CRP). The percentages of plasma CD3, CD4 and CD8 in 6 children diagnosed as KD were determined by flow cytometry . Results The levels of plasma tumor necrosis factor alpha, interleukin-1 beta and interferon gamma in acute KD children were (11.69 ± 3.01) ng / L, (89.25 ± 26.28) ng / L and (31.18 ± 15.34) ng / L, (RIL-1β = 0.887, rTNF-α = 0.875) and the total number of peripheral blood leukocytes were significantly higher than those in the control group (P <0.005, <0.001 and < (RIL-1β = 0.643, rTNF-α = 0.736). The percentages of CD4 in acute lymphocyte increased (30.6 ± 8.96) and CD8 (23.3 ± 6.25) CD8 ratio increased significantly (1.3 ± 0.06). There was a significant linear relationship between the size of left coronary artery, the content of γ-IFN, the size of anterior descending artery and the content of TNF-α, IL-1β and γ-IFN. Conclusion Kawasaki disease in the acute phase of T lymphocyte regulatory network imbalance exists. Understanding the role of cytokines in the pathogenesis of KD is of great importance for the treatment of KD.