临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (4): 241-.doi: 10.3969/j.issn.1000-3606.2019.04.001

• 免疫性疾病专栏 •    下一篇

川崎病患儿血小板表面PAC-1 表达水平变化及意义

郑晨1,2,黎璇1,丁粤粤1,徐秋琴1,曹磊1,沈洁1,孙凌1,吕海涛1,陈烨1   

  1. 1.苏州大学附属儿童医院心内科(江苏苏州 215025);2.苏州大学附属常熟医院 常熟市第一 人民医院儿科(江苏常熟 215500)
  • 出版日期:2019-04-15 发布日期:2019-04-18
  • 通讯作者: 陈烨 电子信箱:chengye20080921@sina.com

The changes and clinical significance of platelet surface expression of PAC-1 in Kawasaki disease in children

 ZHENG Chen1,2, LI Xuan1, DING Yueyue1, XU Qiuqin1, CAO Lei1, SHEN Jie1, SUN Ling1, LYU Haitao1, CHEN Ye1   

  1. 1.Department of Pediatric Cardiology, Children’s Hospital of Soochow University, Suzhou 215025, Jiangsu, China; 2.Department of Pediatrics, Changshu Hospital Affiliated Soochow University, Changshu No.1 People's Hospital, Changshu 215500, Jiangsu, China
  • Online:2019-04-15 Published:2019-04-18

摘要:  目的 探讨川崎病(KD)患儿不同时期血小板表面血小板膜糖蛋白Ⅱb/Ⅲa 纤维蛋白原受体(PAC-1)表达水 平的变化,并分析其与KD冠状动脉损害的相关性。方法 以2016年3—9月住院KD患儿为研究对象(27例),同时设发热 对照组(36例)和健康对照组(40例);KD患儿根据超声心动图检查进一步分为冠状动脉损伤(CAL)组和无冠状动脉损伤 (NCAL)组。采集各组儿童外周静脉血,采用流式细胞仪检测PAC-1表达水平。结果 KD患儿在急性期、亚急性期和恢 复期,与发热及健康对照组的血小板PAC-1表达水平差异有统计学意义(P<0.001),健康对照组最低;KD患儿在亚急性 期血小板PAC-1表达水平最高,其次为急性期和恢复期。亚急性期时,CAL组血小板PAC-1表达水平较NCAL组明显升高, 差异有统计学意义(P<0.05)。 结论 KD患儿在整个病程中血小板PAC-1表达水平升高,提示存在血小板活化;KD患儿 亚急性期PAC-1表达水平升高最明显,且CAL组较NCAL组明显升高,提示血小板活化与KD冠状动脉损伤相关。

关键词: 川崎病; 血小板膜糖蛋白Ⅱb/Ⅲa 纤维蛋白原受体; 血小板活化; 冠状动脉损伤

Abstract: Objective To investigate the changes of platelet surface expression of glycoprotein Ⅱb/Ⅲa fibrinogen receptor (PAC-1) in Kawasaki disease (KD) patients at different phases, and to analyze the correlation between PAC-1 and coronary artery lesion in KD. Method A total of 27 hospitalized children with KD from March to September 2016 were selected as study subjects, and fever control group (36 cases) and healthy control group (40 cases) were set at the same time. KD children were further divided into coronary artery injury (CAL) group and non-coronary artery injury (NCAL) group according to echocardiography. Peripheral venous blood was collected in each group and the expression of PAC-1 was detected by flow cytometry. Results The platelet expression levels of PAC-1 in children with KD in the acute, subacute, and convalescent stages were significantly different from those in the fever and healthy control groups (P<0.001), with the lowest expression levels in the healthy control group. The expression of PAC-1 in KD children was the highest in subacute stage, followed by acute stage and convalescence stage. The expression of PAC-1 in CAL group in subacute phase was significantly higher than that of NCAL group, and the difference was statistically significant (P<0.05). Conclusion The expression levels of platelet PAC-1 were increased throughout the course of the disease in children with KD, indicating the presence of platelet activation. The expression levels of PAC-1 were significantly increased in the subacute phase of KD children, and were significantly higher in the CAL group than in the NCAL subgroup, suggesting that platelet activation was associated with KD coronary artery injury.

Key words: Kawasaki disease; platelet surface expression of glycoprotein Ⅱb/Ⅲa fibrinogen receptor; platelet activation; coronary artery lesion