Platelet-Derived Microparticles: A New Index of Monitoring Platelet Activation and Inflammation in Kawasaki Disease
Platelet-Derived Microparticles: A New Index of Monitoring Platelet Activation and Inflammation in Kawasaki Disease
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DOI：
10.1007/s12098-018-2765-2
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发表时间：
2019-03-01
影响因子：
4.3
通讯作者：
Yu, Haiguo
中科院分区：
文献类型：
--
作者：
Jin, Jing;Wang, Jing;Yu, Haiguo
目的探讨川崎（KD）患儿血小板衍生微颗粒（PtM）的动态变化及其临床意义，并探讨其与静脉免疫球蛋白（IVIG）抵抗、炎症指标及阿司匹林治疗的关系。对照组为20例年龄、性别相匹配的常见发热性疾病患儿。分别于静脉注射IVIG前、静脉注射IVIG后7-10 d及发病后1、2、3 mo抽取静脉血，用酶联免疫吸附试验（ELISA）测定血浆中PdR浓度。结果IVIG治疗前KD患儿血清中P β 1水平明显高于正常对照组（P <0.0001），血清中IL-6、TNF-α、sIL-2 R水平明显高于正常对照组（P < 0.0001）。川崎病患儿静脉注射丙种球蛋白后7 ~ 10 d血清孕酮水平显著下降（P < 0.0001），1 ~ 2 mo降至最低水平。部分患儿的血浆孕酮水平在治疗后3个月内回升（P = 0.047）。此外，IVIG抵抗儿童的P13平均水平高于IVIG有效儿童，但两组之间无显著差异（P = 0.1945）。结论PCRP可作为KD患儿急性期炎症反应的监测指标，PCRP与hs-CRP、IL-6、sIL-2 R水平呈正相关，与ESR、PCT、TNF-α水平无相关性。KD患者血小板活化的持续时间具有个体化特点。
Objective 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.Methods 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-alpha (TNF-alpha), and Soluble interleukin-2 (sIL-2R)] were also measured.Results 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-alpha levels.Conclusions 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.