基质金属蛋白酶及其抑制剂在川崎病患儿冠脉损害中的临床意义

摘要

目的 研究川崎病(KD)患儿血清基质金属蛋白酶3(MMP-3)、基质金属蛋白醇抑制剂1(TIMP-1)的表达水平,探讨其在KD冠脉损害中的临床意义.方法 研究组为30例川崎病患儿,冠脉损害(CAL)组15例,冠脉正常(NCAL)组15例,分别收集急性期、恢复期外周血制备血清.对照组为30例年龄相仿的正常健康儿童.用酶联免疫吸附实验(ELISA)测定各组患儿血清中MMP-3、TIMP-1的水平.结果 川崎病CAL组血清MMP-3、MMP-3/TIMP-1和NCAL组相比明显升高(P＜0.05) ;CAL组血清TIMP-1水平较NCAL组明显降低(P＜0.01).KD急性期MMP-3、TIMP-1、MMP-3/TIMP-1与恢复期和正常对照组相比较均明显升高(P＜0.01).结论 川崎病CAL组血清MMP-3和NCAL组相比明显升高,提示MMP-3可以作为预测与早期诊断CAL的客观指标.KD急性期MMP-3、TIMP-1、MMP-3/TIMP-1水平明显高于恢复期和对照组,提示MMP-3、TIMP-1、MMP-3/TIMP-1可作为早期诊断川崎病的一个客观生化指标.%Objective To explore the expression of MMP-3 and TIMP-1 in Kawasaki disease and discuss their significance in the coronary artery lesion(CAL)with KD. Methods The serum was collected from 30 KD children (15 patients with coronary arterial lesions, group CALi and 15 patients with no coronary arterial lesions.group NCAL.) Serum collection with KD in the acute phase and convalescence phase. Control group:30 normal children with the similar age. The levels of MMP-3. TIMP-1, were detected by Enzyme-linked immunosorbent assay ( ELISA ) in serum. Results MMP-3 and MMP-3/TIMP-1 of group CAL are compared with group NCAL, were significantly higher than that in group NCAL(P<0.05). TIMP-1 of group NCAL is compared with group CAL,is significantly higher than that in group CAL (P<0. 01); acute phase and convalescence phase MMP-3,TIMP-1 and the ratio of MMP-3/TIMP-1 level are compared with Normal control group are significantly higher than that in group normal(P<0. 01). Conclusion MMP-3 of group CAL is significiantly higher than group NCAL, Therefore,the measurement of serum MMP-3 might be of important clinical value in the prediction and the early diagnosis of KD with coronary artery lesion. In acute stage serum MMP-3 and TIMP-1 levels and the ration of MMP-3/TIMP-1 were higher in patients with KD than that in convalescent stage and control groupt suggesting that these data are important objective markers with diagnosis KD in early stage.