静脉注射免疫球蛋白敏感型川崎病和静脉注射免疫球蛋白抵抗型川崎病患儿炎症细胞因子水平与预后的相关性
Correlation between the Level of Inflammatory Cytokines and Prognosis in Children with IVIG-sensitive Kawasaki Disease and IVIG-resistant Kawasaki Disease.
作者信息
Zhang Hao, Song Hao-Bin, Wang De-Xing, Deng Hong-Yu, Sun Wen-Long
机构信息
Hao Zhang, Department of Cardiology, Baoding Children's Hospital, Baoding 071000, China; Department of Cardiology, Baoding City Children Respiratory and Digestive Diseases Clinical Research key Laboratory, Baoding 071000, China.
Hao-bin Song, Department of Laboratory Medicine, Baoding Children's Hospital, Baoding 071000, China; Department of Cardiology, Baoding City Children Respiratory and Digestive Diseases Clinical Research key Laboratory, Baoding 071000, China.
出版信息
Pak J Med Sci. 2022 May-Jun;38(5):1165-1169. doi: 10.12669/pjms.38.5.5408.
OBJECTIVES
To investigate whether the levels of interleukin 1β (IL-1β), interferon γ (IFN-γ), tumor necrosis factor α (TNF-α) in children with Kawasaki disease (KD) are correlated with coronary artery lesion (CAL) and resistance to intravenous immunoglobulin (IVIG) treatment.
METHODS
A total of 216 children in line with KD diagnostic criteria were continuously included as subjects, and 50 healthy children at the same period were selected as the control group, and their levels of IL-1β, IFN-γ, and TNF-α were detected.
RESULTS
Subjects were subdivided according to the presence or absence of CAL: 42 cases (19.4%) of 216 children with KD developed CAL and were subdivided into the CAL group, while 174 (80.6%) of those who did not develop CAL were subdivided into the NCAL group. The levels of IL-1β, IFN-γ, and TNF-α in the CAL group and the NCAL group were higher than those in the control group (P<0.05), and the levels of those in the CAL group were higher than those in the NCAL group (P<0.05). Subjects were subdivided according to the effect of IVIG treatment: 194 cases (89.8%) of 216 children with KD had a good control of inflammation after the initial IVIG treatment, and were considered to have IVIG-sensitive KD and divided into the IVIG-sensitive group; 22 cases (10.2%) could not get good control of inflammation after the initial IVIG treatment, and were considered to have IVIG-resistant KD and divided into the IVIG-resistant group. The levels of IL-1β, IFN-γ, and TNF-α in the IVIG-sensitive group and the IVIG-resistant group were higher than those in the control group; The levels of IL-1β, IFN-γ, and TNF-α in the IVIG-resistant group were higher than those in the IVIG-sensitive group (P<0.05), while the fever time of the IVIG-sensitive group was lower than that of the IVIG-resistant group (P<0.05).
CONCLUSION
Children with KD may experience changes in IL-1β, IFN-γ, and TNF-α levels in the acute phase. Such a significant increase in levels may be a risk factor for CAL and resistance to IVIG treatment in children with KD, while the prolonged fever time is a risk factor for resistance to IVIG treatment in children with KD.
目的
探讨川崎病（KD）患儿白细胞介素1β（IL-1β）、干扰素γ（IFN-γ）、肿瘤坏死因子α（TNF-α）水平与冠状动脉病变（CAL）及静脉注射免疫球蛋白（IVIG）治疗抵抗是否相关。
方法
连续纳入216例符合KD诊断标准的患儿作为研究对象，选取同期50例健康儿童作为对照组，检测其IL-1β、IFN-γ及TNF-α水平。
结果
根据是否存在CAL将研究对象进行分组：216例KD患儿中42例（19.4%）发生CAL，分为CAL组；174例（80.6%）未发生CAL的患儿分为无CAL组（NCAL组）。CAL组和NCAL组患儿的IL-1β、IFN-γ及TNF-α水平均高于对照组（P<0.05），且CAL组患儿上述指标水平高于NCAL组（P<0.05）。根据IVIG治疗效果将研究对象进行分组：216例KD患儿中194例（89.8%）在初次IVIG治疗后炎症得到良好控制，被认为是IVIG敏感型KD，分为IVIG敏感组；22例（10.2%）在初次IVIG治疗后炎症未得到良好控制，被认为是IVIG抵抗型KD，分为IVIG抵抗组。IVIG敏感组和IVIG抵抗组患儿的IL-1β、IFN-γ及TNF-α水平均高于对照组；IVIG抵抗组患儿的IL-1β、IFN-γ及TNF-α水平高于IVIG敏感组（P<0.05），而IVIG敏感组患儿的发热时间低于IVIG抵抗组（P<0.05）。
结论
KD患儿急性期可能出现IL-1β、IFN-γ及TNF-α水平变化。这些水平的显著升高可能是KD患儿发生CAL及IVIG治疗抵抗的危险因素，而发热时间延长是KD患儿IVIG治疗抵抗的危险因素。
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