The Clinical Study On Associative Factors Of Coronary Artery Damage In Children With Kawasaki Disease

Objective: Kawasaki disease (kawasaki disease, KD) is systemic vasculitis of the main acute lesions, fever, rash disease. In recent years, with the progress of technology and scientific development, as well as clinicians to raise awareness of the disease, the global incidence rate has increased year by year trends. The disease mainly involving small blood vessels, in particular Coronary artery disease is the damage to the main hazards, and some children in the acute phase or after the formation of coronary artery dilatation, coronary artery aneurysms and multiple narrow, serious threat to the quality of life for children with life or safety of the children acquired heart disease One of the important factors. However, the pathogenesis of this disease is not very clear, but more than that KD is a variety of sexually transmitted infections from the original trigger abnormal activation of the immune system caused by vasculitis that systemic immune activation, and increased cytokine production of autoantibodies increase is the KD characteristics. KD plasma in the presence of circulating antibody, such as cytoplasmic antibodies, anti-endothelial cell antibodies, anticardiolipin antibody, their IL-1β, TNFαor IFN-γstimulated endothelial cells with cytotoxic effect However, their specificity still controversial, and the vascular injury may occur process.Β2GPI is a relatively rich plasma glycoprotein is to determine the ACA and cardiac combination of phospholipid cofactor, in some autoimmune diseases is an important autoantigen, immune activation in endothelial cells, vascular inflammation and thrombosis formation process from the role of crucial importance, especially anti-β2GP1 the emergence of antibodies increased the risk of thrombosis. At the same time a specific collagenase and elastase activity in the zinc-dependent matrix metalloproteinase superfamily of MMP-9, can degrade collagen from the main organization, flexible hardware protein, a protein vascular endothelial polysaccharide lower in inflammation in response to inflammatory cells such as T-lymphocytes, monocytes macrophages to the vascular wall deep Mobile, immune injury to the blood vessel wall deep development. MMP-9 through the degradation of extracellular matrix, in atherosclerotic vascular remodeling and plaque instability caused by cardiovascular diseases in the development process plays an important role. Some scholars study the use of high-fat meal-induced rabbit model of atherosclerosis found in atherosclerosis and progress with the process of activation of MMPs, and gradually increasing trend. In recent years, studies indicate that the pathogenesis of Kawasaki disease there is a clear anti-β2GPI antibody and matrix metalloproteinase-9 (MMP-9) increased, and two in Kawasaki disease, development and progress of coronary artery damage to the merger process, which they have close relationship. This study aimed to investigate the acute phase of Kawasaki disease in children with serum anti-β2 GPI antibody, MMP-9 levels of Kawasaki disease in the early diagnosis and prediction of the value of coronary artery disease.Methods: First Clinical Hospital of Jilin University Pediatric clear diagnosis of KD 37 cases of children hospitalized for observation group, which Doppler ultrasound examination of 20 cases with normal coronary artery, the merger were 17 cases of coronary artery disease. Replacement of 20 cases in our hospital during the same period in the age of diagnosis was similar to sepsis or pneumonia and other infectious diseases in children with fever control group, all except for the heart, liver, kidney, blood diseases and autoimmune diseases such as rheumatoid. By ELISA measurement of serum antibody anti-β2GPI, MMP-9 levels. Using SAS software analysis of the data collected, testedα= 0.05 level.Results: Observer Group in children with Kawasaki disease and fever in the control group, serum anti-β2GPIantibody levels are 8.0595±1.9177U/ml and 5.21±1.1259U/ml; serum levels of MMP-9 is 912.73 and 790±87.396ng/ml 14.712ng/ml, the two were significantly different, the statistical test statistically significant (P<0.05); Observer Group coronary artery and coronary artery injury group were normal serum level of anti-β2GPI serum antibody levels are 9.3118±2.1482 U/ml and 6.995±0.697U/ml, serum levels of MMP-9 is 979.71±90.559ng/ml and 855.8±11.87ng/ml, the two were significantly different statistically the test statistical significance (P<0.05) in children with Kawasaki disease observed in the serum MMP-9, anti-β2GP1antibody levels were significantly correlated with a correlation coefficient r=0.66533, (P<0.0001).Conclusion: Anti-β2GPI antibody and MMP-9 in the acute phase of Kawasaki disease with coronary artery disease, particularly significantly increased, and they may be involved in the Kawasaki disease are especially coronary vasculitis injury expansion of the pathologic process, suggesting that anti-β2GPI antibody and MMP﹣9 and KD have a strong correlation, the early diagnosis of Kawasaki disease may become serological indicators, in particular, may be a sign of coronary artery lesions KD indicators at the same time both in Kawasaki disease may occur in the process of the development of synergies. This early diagnosis and prediction of the merger of Kawasaki disease and coronary artery disease early clinical drug guide has important theoretical and clinical significance.