【摘要】 目的 通过对川崎病(KD)患儿血清基质金属蛋白酶(MMP)-9及其抑制物组织基质金属蛋白酶抑制物(TIMP)-1水平的测定,探讨MMP-9及TIMP-1与川崎病发病及其冠状动脉并发症发生发展的关系。方法 采用酶联免疫吸附检测(ELISA)法对30例KD无冠状动脉病变(CAL)及9例KD合并CAL患儿急性期和恢复期血清MMP-9、TIMP-1水平进行检测,并与15例其他发热性疾病患儿及18例正常健康儿童进行对照。结果急性期KD有CAL组和无CAL组血清MMP-9、TIMP-1、MMP-9／TIMP-1分别是896.2±81.7、342.6±43.1、2.5±0.6和284.3±40.9、389.5±20.8、0.8±0.2,均较发热对照组及正常对照组(87.9±18.9、251.5±13.0、0.3±0.1和24.6±2.8、90.0±4.2、0.3±0.02)明显增加(P<0.01),且有CAL组的MMP-9及MMP-9／TIMP-1较无CAL组增高更为显著(P<0.01);恢复期KD无CAL组患儿血清MMP-9、TIMP-1、MMP-9／TIMP-1降至正常水平(26.4±7.6、95.6±5.8、0.2±0.1),而有CAL组患儿虽较急性期亦明显下降(220.0±28.3、258.9±15.0、0.9±0.3),但仍然明显高于正常对照组(分别P<0.01和P<0.05),发热对照组血清MMP-9及TIMP-1水平亦较正常对照组明显增高(P<0.01),但其MMP-9／TIMP-1与正常对照组比较差异无显著性(P>0.05)。结论 MMP-9及TIMP-1参与了川崎病的病理生理过?更多还原

【Abstract】 Objective To investigate the clinical significance of matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of matrix metalloproteinase 1 (TIMP-1) levels in the pathogenesis of Kawasaki disease (KD) and its complication of coronary arterial lesions (CAL). Methods Serum levels of MMP-9 and TIMP-1 were measured by ELISA in 30 KD children without CAL, 9 KD children with CAL, and 33 non-KD controls (15 febrile and 18 afebrile children) . Blood samples from children with KD were obtained during the acute and convalescent stage respectively. Results MMP-9 and TIMP-1 levels and MMP-9/TIMP-1 ratio were significantly elevated during the acute phase in the two groups of KD children, compared to those of febrile and afebrile non-KD controls (P< 0.01). Furthermore, MMP-9 level and MMP-9/TIMP-1 ratio were significantly higher in KD children with CAL than in KD children without CAL (P<0.01). More importantly, although MMP-9 level and MMP-9/TIMP-1 ratio during the convalescent stage of the two groups of KD children were markedly decreased when compared to those during the acute stage, the MMP-9 level and MMP-9/TIMP-1 ratio of KD children with CAL were still significantly higher than that of KD children without CAL and that of the controls. Although MMP-9 and TIMP-1 levels in febrile controls were significantly higher than those of afebrile controls, the MMP-9/ TIMP-1 ratio of febrile controls and afebrile controls were comparable ( P > 0.05 ). Conclusion MMP-9 and TIMP-1 may be involved in the pathophysiological process of KD and its complication of CAL, and high levels of MMP-9 and/or MMP-9/TIMP-1 are susceptible to CAL.更多还原