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目的探讨川崎病(Kawasaki disease,KD)患儿急性期及恢复期全血血小板CD41和CD61含量变化的临床意义。方法将2009年1月～2009年12月在山西省儿童医院收治的25例川崎病患儿,分为治疗前(急性期)和治疗后(恢复期),对照组为16例体检正常儿童。用流式细胞仪检测血小板CD41、CD61的表达水平。用超声心电图观察KD患儿心脏冠状动脉的变化并将其分为冠状动脉损伤(CAL)组和非冠状动脉损伤(NCAL)组。结果 KD患儿急性期、恢复期的CD41和CD61与对照组分别比较,差异有统计学意义(P<0.05);但KD急性期CD41表达水平与恢复期比较差异无统计学意义(P>0.05),而KD急性期CD61表达水平与恢复期比较,差异具有统计学意义(P<0.05)。25例患儿中合并冠状动脉组CD41与未合并冠状动脉组CD41表达水平差异有统计学意义(P<0.05),而CD61表达水平比较差异无统计学意义(P>0.05)。结论血小板CD41和CD61的表达水平对判断KD的早期诊断及血管病变有重要临床价值。
Objective To investigate the clinical significance of the changes of CD41 and CD61 in whole blood platelets in acute and convalescent children with Kawasaki disease (KD). Methods Twenty-five children with Kawasaki disease admitted to Children’s Hospital of Shanxi Province from January 2009 to December 2009 were divided into pre-treatment (acute phase) and post-treatment (recovery phase), and the control group was 16 normal children. Flow cytometry was used to detect the expression of platelet CD41 and CD61. Coronary artery changes in children with KD were observed by echocardiography and divided into coronary artery injury (CAL) group and non-coronary artery injury (NCAL) group. Results The acute and convalescent CD41 and CD61 in children with KD were significantly different from those in the control group (P <0.05). However, there was no significant difference in the expression level of CD41 between KD and recovery stage (P> 0.05 ), While the expression level of CD61 in KD acute phase compared with recovery period, the difference was statistically significant (P <0.05). There were significant differences in CD41 expression between CD41 and coronary artery in 25 patients with coronary artery disease (P <0.05), but there was no significant difference in CD61 expression between the two groups (P> 0.05). Conclusion The expression of platelet CD41 and CD61 have important clinical value in judging the early diagnosis of KD and vascular lesions.