川崎病患儿外周血CD15抗原表达相关研究
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摘要
目的探讨川崎病(KD)患儿外周血CD15抗原表达水平与临床各指标尤其是冠状动脉损害(CALs)的相关性。方法选择100例KD患儿,其中20例合并CALs;另选53例急性期肺炎患儿、49例急性期过敏性紫癜(AP)患儿及110例正常儿童作为对照。检测各组急性期患儿及恢复期KD患儿外周血CD15+淋巴细胞及单核细胞百分比,并进行比较和相关性分析。结果急性期KD患儿外周血CD15+淋巴细胞百分比明显高于正常儿童、肺炎及AP患儿,差异均有统计学意义(P<0.01);KD患儿中,CALs组外周血CD15+淋巴细胞百分比明显高于无CALs组,差异有统计学意义(P<0.0001)。恢复期KD患儿外周血CD15+淋巴细胞百分比明显下降,与急性期差异有统计学意义(P<0.01),而与正常儿童差异无统计学意义(P>0.05)。Spearman相关分析显示,急性期KD患儿CRP水平与外周血CD15+淋巴细胞百分比呈正相关(P<0.001)。结论 CD15抗原在KD急性期的高表达可能与KD发病机制有关,可协助早期预测CALs。
Objectives To explore the correlation between the expression of CD15 antigen in peripheral blood and the clinical factors,especially coronary artery lesion(CALs),in Kawasaki disease(KD).Methods One-hundred children with KD were included in the study and 20 of them complicated with CALs.Fifty-three children with pneumonia,49 children with anaphylactoid purpura(AP) and 110 health children were enrolled as the control group.The percentages of CD15+ lymphocytes as well as monocytes in peripheral blood were tested during acute and convalescent stage of KD.Results During the acute stage,significantly higher percentage of CD15+ lymphocytes was found in KD patients than that of healthy control,pneumonia and AP group(all P<0.01).The percentage of CD15+ lymphocytes in KD patients with CALs was significantly higher than that of patients without CALs(P<0.0001).In KD patients,the percentage of CD15+ lymphocytes declined significantly during the convalescent stage than that during the acute stage(P<0.01),and no statistical significance was observed comparing with the healthy control group(P>0.05).Significant positive correlations of C-reaction protein(CRP) with percentage of CD15+ lymphocytes in acute KD patients were revealed by Spearman correlations study(P<0.0001).Conclusions The over expression of CD15 antigen in acute KD patients may relate to the pathogenesis of KD and can assist the early prediction of CALs.
Objectives To explore the correlation between the expression of CD15 antigen in peripheral blood and the clinical factors,especially coronary artery lesion(CALs),in Kawasaki disease(KD).Methods One-hundred children with KD were included in the study and 20 of them complicated with CALs.Fifty-three children with pneumonia,49 children with anaphylactoid purpura(AP) and 110 health children were enrolled as the control group.The percentages of CD15+ lymphocytes as well as monocytes in peripheral blood were tested during acute and convalescent stage of KD.Results During the acute stage,significantly higher percentage of CD15+ lymphocytes was found in KD patients than that of healthy control,pneumonia and AP group(all P<0.01).The percentage of CD15+ lymphocytes in KD patients with CALs was significantly higher than that of patients without CALs(P<0.0001).In KD patients,the percentage of CD15+ lymphocytes declined significantly during the convalescent stage than that during the acute stage(P<0.01),and no statistical significance was observed comparing with the healthy control group(P>0.05).Significant positive correlations of C-reaction protein(CRP) with percentage of CD15+ lymphocytes in acute KD patients were revealed by Spearman correlations study(P<0.0001).Conclusions The over expression of CD15 antigen in acute KD patients may relate to the pathogenesis of KD and can assist the early prediction of CALs.
引文
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[15]Mitani Y,Sawada H,Hayakawa H,et al.Elevated levels ofhigh-sensitivity C-reactive protein and serum amyloid-A lateafter Kawasaki disease:association between inflammation andlate coronary sequelae in Kawasaki disease[J].Circulation,2005,111(1):38-43.
[2]Lin IC,Kuo HC,Lin YJ,et al.Augmented TLR2 expressionon monocytes in both human Kawasaki disease and a mousemodel of coronary arteritis.[J].PLoS One,2012,7(6):e38635.
[3]Oza k i Y,I man ish i T,Ta r uya A,et al.Ci rculating CD14+CD16+monocyte subsets as biomarkers of the severity ofcoronary artery disease in patients with stable angina pectoris[J].Circ J,2012,76(10):2412-2418.
[4]Ichiyama T,Ueno Y,Hasegawa M,et al.Intravenous im-munoglobulin does not increase FccRIIB expression onmonocytes/macrophages during acute Kawasaki disease[J].Rheumatology(Oxford),2005,44(3):314–317.
[5]Tübel J,Saldamli B,Wiest I,et al.Expression of the tumormarkers sialyl Lewis A,sialyl Lewis X,Lewis Y,Thomsen-Friedenreich antigen,galectin-1 and galectin-3 in human os-teoblasts in vitro[J].Anticancer Res,2012,32(5):2159-2164.
[6]Yu J,Zhang Y,Zhang X,et al.Endothelium derived nitricoxide synthase negatively regulates the PDGF-survivin path-way during flow-dependent vascular remodeling[J].PLoSOne,2012,7(2):e31495.
[7]JCS Joint Working Group.Guidelines for diagnosis and man-agement of cardiovascular sequelae in Kawasaki Disease(JCS2008)--digest[J].Circ J,74(9):1989-2020.
[8]Lic C,Bayer A,Cosgrove SE,et al.Clinical practice guide-lines by the infectious diseases society of america for the treat-ment of methicillin-resistant Staphylococcus aureus infectionsin adults and children[J].Clin Infect Dis,2011,53(3):e18-55.
[9]Evidence-based guidelines on diagnosis and treatment of child-hood common renal diseases(II):evidence-based guideline ondiagnosis and treatment of Henoch-Schonlein purpura nephri-tis[J].Zhonghua Er Ke Za Zhi,2009,47(12):911-913.
[10]Falcini F.Kawasaki disease[J].Curr Opin Rheumatol,2006,18(1):33-38.
[11]Brogan PA,Shah V,Rlein N,et al.Vbeta-restricted T celladherence to endothelial cells a mechanism for superantigen-dependent vascular injury[J].Arthritis Rheum,2004,50(2):589-597.
[12]Moiseeva EP,Leyland ML,Bradding P.CADM1 is expressedas multiple alternatively spliced functional and dysfunctionalisoforms in human mast cells[J].Mol Immunol,2013,53(4):345-354.
[13]Miura M,Garcia FL,Crawford SE,et al.Cell adhesion mol-ecule expression in coronary artery aneurysms in acute Kawa-saki disease[J].Pediatr Infect Dis J,2004,23(10):931-936.
[14]Burdick MM,Henson KA,Delgadillo LF,etal.Expression ofE-selectin ligands on circulating tumor cells:cross-regulationwith cancer stem cellregulatory pathways[J].Front Oncol,2012,2:103.
[15]Mitani Y,Sawada H,Hayakawa H,et al.Elevated levels ofhigh-sensitivity C-reactive protein and serum amyloid-A lateafter Kawasaki disease:association between inflammation andlate coronary sequelae in Kawasaki disease[J].Circulation,2005,111(1):38-43.