Children's Hospital of Nanjing Medical University, Nanjing, China.
Nanjing Tongren Hospital, School of Medicine Southeast University, Nanjing, China.
Indian J Pediatr. 2019 Mar;86(3):250-255. doi: 10.1007/s12098-018-2765-2. Epub 2018 Aug 30.
To investigate the dynamic changes of platelet-derived microparticles (PDMP) in Kawasaki disease (KD) and its clinical significance and to study its relationship with intravenous immunoglobulin (IVIG) resistance, inflammatory indicators and aspirin treatment in children with KD.
Twenty children with KD were enrolled as the experimental group, while 20 age- and gender-matched children with common febrile disease were included in the control group. Blood samples were drawn before and 7-10 d after IVIG infusion and thereafter at 1, 2, and 3 mo after the onset of KD to estimate the PDMP concentrations by enzyme linked immunosorbent assay (ELISA). C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), and cytokines [Interleukin-6 (IL-6), Tumor necrosis factor-α (TNF-α), and Soluble interleukin-2 (sIL-2R)] were also measured.
The level of PDMP in KD children before IVIG was significantly higher than that in controls (P < 0.0001). The PDMP level in KD children decreased significantly at 7 to 10 d after IVIG (P < 0.0001) and then decreased to the lowest level in the course of 1 to 2 mo. Some children's PDMP level rebounded in the course of 3 mo (P = 0.047). In addition, the mean level of PDMP in IVIG-resistant children was higher than that in IVIG-effective children; however, there was no significant difference between the two groups (P = 0.1945). Furthermore, PDMP was positively correlated with hs-CRP, IL-6, and sIL-2R levels, but no correlation was observed with ESR, PCT, and TNF-α levels.
PDMP can be used as an index to monitor inflammation in children at the acute stage of KD. And the duration of platelet activation in KD is individualized.
探讨川崎病（KD）患儿血小板衍生微颗粒（PDMP）的动态变化及其临床意义，并研究其与静脉注射免疫球蛋白（IVIG）抵抗、炎症指标及阿司匹林治疗的关系。
选择 20 例 KD 患儿为实验组，选择同期年龄、性别匹配的 20 例普通发热患儿为对照组。分别于 IVIG 输注前及输注后 7~10 d 、发病后 1、2、3 个月采血，采用酶联免疫吸附试验（ELISA）检测 PDMP 浓度，同时检测 C 反应蛋白（hs-CRP）、红细胞沉降率（ESR）、降钙素原（PCT）、细胞因子[白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、可溶性白细胞介素-2 受体（sIL-2R）]。
KD 患儿 IVIG 前 PDMP 水平明显高于对照组（P<0.0001），IVIG 后 710 d 显著下降（P<0.0001），12 个月降至最低，部分患儿在 3 个月时出现反弹（P=0.047）。IVIG 抵抗组患儿 PDMP 均值高于 IVIG 有效组，但两组间比较差异无统计学意义（P=0.1945）。PDMP 与 hs-CRP、IL-6、sIL-2R 呈正相关，与 ESR、PCT、TNF-α无相关性。
PDMP 可作为 KD 患儿急性期炎症监测指标，且 KD 患儿血小板激活持续时间存在个体差异。
