摘要
目的：探讨血清胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3（IGFBP3）在川崎病病程及其治疗中的改变和临床意义。方法：川崎病组患儿分别于治疗前（病程第8天）、治疗后2、5天（病程第10、13天）采静脉血，其他感染性疾病组患儿于入院第1天及入院第5天采静脉血。以上标本均采用ELISA法进行IGF-1、IGFBP3测定。结果：（1）川崎病组治疗前（病程第8天）的IGF-1、IGFBP3血清水平较正常对照组升高（P<0.05），而与其他感染性疾病组（入院时）相比无显著性差异。（2）川崎病组治疗后2天（病程第10天），其血清IGF-1、IGFBP3水平与治疗前（病程第8天）相比明显升高，有显著性差异（P<0.05）。(3）川崎病组经治疗后5天（病程第13天），血清IGF-1、IGFBP3水平仍持续在高水平，与川崎病治疗后2天（病程第10天）相比无显著性差异，与正常对照组相比，差异有显著性（P<0.01），与其他感染性疾病组（入院后5天）相比明显升高（P<0．05）；其他感染性疾病组（入院时）与入院后5天血清IGF-1、IGFBP3水平相比无显著性差异（P>0.05）。(4）川崎病组分为发生CAL组和未发生CAL组，两组IGF-1、IGFBP3血清水平无显著性差异。（5）川崎病组中分典型KD和不完全KD两组，其治疗前后IGF-1、IGFBP3血清水平无显著性差异。结论：川崎病组患儿治疗后血清IGF-1、IGFBP3水平显著升高，可能与丙种球蛋白大剂量应用有关，其水平升高，可能减少了川崎病后期血管狭窄及血管瘤的形成，其作用机制有待进一步探讨。
Abstract
Objective: To investigate the expression and clinical significance of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding Protein 3 (IGFBP3) in Kawasaki disease.Methods: The expression of IGF-1 and IGFBP3 in KD group serum blood, its course of the day 8、10、13 , were detected by means of ELISA. The serum levels of IGF-1 and IGFBP3with the infectious diseases group were detected by means of ELISA, in the hospital the first day and fifth day.Results: (1) The levels of serum IGF-1,IGFBP3 on the duration of 8 days in Kawasaki disease were higher than normal control group, compared with other infectious diseases group were not significant. (2)The duration of 10 days in Kawasaki disease , the serum IGF-1, IGFBP3 levels were significantly higher than the duration of 8 days .(P <0.05).(3)The duration of 13 days in Kawasaki disease , the serum IGF-1,IGFBP3 levels are stil continuing at high levels,compared with the duration of 10 days were not significant, compared with the normal control group , the difference was significant (P <0.01), compared with other infectious disease group (admission 5 days) was significantly higher compared (P <0.05). 1 days after admission with other infectious diseases group compared with 5 days after admission,the serum IGF-1,IGFBP3 levels showed no significant difference (P> 0.05).(4)Kawasaki disease patients were divided into two groups, with CAL group and without CAL group, two groups of IGF-1, IGFBP3 serum levels were not significantly different.(5) Typical Kawasaki disease group and atypical Kawasaki disease group, before and after treatment ,the IGF-1, IGFBP3 serum levels were not significantly different.Conclusion: After treatment with Kawasaki disease children ,the serum IGF-1, IGFBP3 levels were significantly increased, a large dose of gamma globulin related to its level rises possibly, it may reduce the Kawasaki disease and vascular stenosis late aneurysm formation, and its mechanism needs further study.
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