川崎病患儿内源性血管弹性蛋白酶变化及其与冠脉损伤的关系

摘要

Objective To explore the potential role of endogenous vascular elastase (EVE) in pathogenesis of coronary ar-tery lesions (CAL) in Kawasaki diseases (KD). Methods A total of 60 children with KD admitted from Jan. 2012 to Apr. 2013 were enrolled, and at the same time 60 febrile children with respiratory infection were enrolled as controls. The left and right coro-nary artery diameter value was measured by ultrasonic cardiogram. The levels of EVE, matrix metalloproteinases (MMP)-9 and transforming growth factor (TGF)-β1were determined by enzyme-linked immunosorbent assay and their correlations with coro-nary artery diameter were analyzed. Results The levels of EVE, MMP-9 and TGF-β1 in KD children in the acute phase were significantly higher than those in control group (P<0.01). Meanwhile, the level of EVE in KD children with coronary artery le-sion (CAL) is significantly higher than that in KD children without CAL. The results of correlation analysis indicated that the levels of EVE, MMP-9 and TGF-β1 were positively correlated with coronary artery diameters (r=0.64~0.79, P<0.01). Conclu-sions EVE plays an important role in the CAL of KD may through inducing the produce of MMP-9, TGF-β1 and finally caus-ing the formation of CAL.%目的：探讨内源性血管弹性蛋白酶（EVE）对川崎病（KD）患儿冠脉损害的作用机制。方法选取2012年1月至2013年4月住院治疗的60例KD患儿为研究对象，以同期60例呼吸道感染发热患儿为对照组。采用超声心动图检测患儿冠状动脉扩张程度；采用双抗体夹心酶联免疫吸附法测定血EVE、基质金属蛋白酶9（MMP-9）和转化生长因子β1（TGF-β1），并分析其与冠状动脉直径的相关性。结果 KD患儿急性期血EVE、MMP-9、TGF-β1水平明显高于对照组，差异有统计学意义（P<0.01）；并发冠脉病变的KD患儿的EVE水平明显高于无冠脉损害患儿，且EVE、MMP-9、TGF-β1水平与冠脉扩张程度成显著正相关（r=0.64~0.79，P<0.01）。结论 EVE在KD冠脉病变中，可能是通过诱导MMP-9、TGF-β1合成而引起冠脉损伤。