Immune function examination and its clinical significance in children with Kawasaki's disease
10.3760/cma.j.issn.1007-7480.2012.09.003
- VernacularTitle:川崎病患儿免疫功能的检测及临床价值
- Author:
Yan DING
;
Wei YIN
;
Yuehua XIONG
;
Fang PENG
;
Li LIU
- Publication Type:Journal Article
- Keywords:
Mucocutaneous lymph node syndrome;
T-lymphocyte subsets;
B-lymphocytes
- From:
Chinese Journal of Rheumatology
2012;16(9):588-592
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveThe purpose of the study was to summarize the characteristics of cellular and humoral immunity in children with Kawasaki's disease (KD),and to explore the role of cellular and humoral immunity in the pathogenesis of KD.MethodsOne hundred and ninety-six subjects with KD were diagnosed and observed.The serum IgG,IgM,IgA and C3,C4 levels were detected by velocity scatter turbidimetry.The levels of T lymphocyte subsets,natural killer cells (NK cells),and B cells were analyzed by flow cytometry.Chi-square test,independent t-test and Spearman analysis were adopted to analyze data.ResultsOne hundred and seventy-two cases were diagnosed as typical KD,24 cases were incomplete KD,17 cases were refractory KD,179 cases responded to IVIG therapy,and 34 cases were CAL.The occurrence of coronary artery lesion (CAL) in the refractory KD group was 52.9％,which was evidently higher than those patients responding to IVIG therapy(14.0％,P＜0.05).In the group of KD,the level of CD19 absolute value(1165±556)/μl was higher than that in the control group(P＜0.05),the ratio of CD4/CD8 (2.19±0.77) was higher than that in the control group (P＜0.05),the levels of serum IgM ( 1.41 ±0.45) g/L,IgA (0.81 ±0.35) g/L,C3 ( 1.31 ±0.26) g/L were higher than those in the control group (P＜0.05),the levels of CD8 (671±308)/μl,NK (337±233)/μl absolute value were lower than those in thc control group (P＜0.05).In refractory KD subgroup,the levels of CD19 absolute value,serum IgM,C3 and the ratio of CD4/CD8 were higher than those in the subgroup responding to IVIG therapy(P＜0.05),while the levels of CD8,NK absolute value were lower than those in the latter(P＜0.05).In the CAL subgroup,the levels of CD19 absolute value,serum IgM,IgA and the ratio of CD4/CD8 were higher than those in the non-CAL subgroup (P＜0.05),while the levels of CD8,NK absolute value were lower than those in the latter(P＜0.05).The differences of all data between typical KD subgroup and incomplete KD subgroup were insignificant (P＞0.05).The severity grade of CAL was positively correlated with the ratio of CD4/CD8(P＜0.05).ConclusionThere are cellular immunity and humoral immunity disturbances in the acute stage of KD,while cellular immunity disturbances are more striking.Cellular immunity and humoral immunity are all involved in the pathogenesis of KD.The immunity dysfunction is more significant in refractory KD and CAL.The occurrence rate of CAL is high in refractory KD.The ratio of CD4/CD8 is relevant to the severity of vascular injury.
