川崎病患儿血清胰岛素样生长因子1、胰岛素样生长因子结合蛋白3的变化研究林莉李雪梅（四川省自贡市第一人民医院儿科643000）【摘要】R的：探讨血清胰岛素样生长因子l（IGF-l）、胰岛素样生长因子结合蛋白3（IGFBP3）在川崎病病程及其治疗屮的改变和临床意义。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）o（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CALS,两组IGF-1、IGFBP3血清水平无显著性差异。（5）川崎病组屮分典型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淸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。【关键词】川崎病胰岛素样生长因子1胰岛素样生长因子结合蛋03【】R722.1【文献标识码】A【】1672-5085（2014）21-0068-03ThestudyofthechangeinKawasakidiseasewithchildrenoninsulin-likegrowthfactor1andinsulin-likegrowthfactorbindingProtein3UNLiLIXuemeiWANGGuiIan(DepartmentofPediatrics,FirstPeople'sHospitalofZigongCity,SichuanProvince,643000)【Abstract】Objective:Toinvestigatetheexpressionandclinicalsignificanceofinsulin-likegrowthfactor1(IGF-1)andinsulin-likegrowthfactorbindingProtein3(IGFBP3)inKawasakidisease.Methods:TheexpressionofIGF-1andIGFBP3inKDgroupserumblood,itscourseoftheday8、10、13,weredetectedbymeansofELISA.TheserumlevelsofIGF-1andIGFBP3withtheinfectiousdiseasesgroupweredetectedbymeansofELISA,inthehospitalthefirstdayandfifthday.Results:(1)ThelevelsofserumIGF-1,IGFBP3onthedurationof8daysinKawasakidiseasewerehigherthannormalcontrolgroup,comparedwithotherinfectiousdiseasesgroupwerenotsignificant.(2)Thedurationof10daysinKawasakidisease,theserumIGF-1,IGFBP3levelsweresignificantlyhigherthanthedurationof8days.(P《0.05).(3)Thedurationof13daysinKawasakidisease,theserumIGF-1,IGFBP3levelsarestillcontinuingathighlevels,comparedwiththedurationof10dayswerenotsignificant,comparedwiththenormalcontrolgroup,thedifferencewassignificant(P《0.01),comparedwithotherinfectiousdiseasegroup(admission5days)wassignificantlyhighercompared(P《0.05).1daysafteradmissionwithotherinfectiousdiseasesgroupcomparedwith5daysafteradmission,theserumIGF-1,IGFBP3levelsshowednosignificantdifference(P》0.05).(4)Kawasakidiseasepatientsweredividedintotwogroups,withCALgroupandwithoutCALgroup,twogroupsofIGF-1,IGFBP3serumlevelswerenotsignificantlydifferent.(5)TypicalKawasakidiseasegroupandatypicalKawasakidiseasegroup,beforeandaftertreatment,theIGF-1,IGFBP3serumlevelswerenotsignificantlydifferent.Conclusion:AftertreatmentwithKawasakidiseasechildren,theserumIGF-1,IGFBP3levelsweresignificantlyincreased,alargedoseofgammaglobulinrelatedtoitslevelrisespossibly,itmayreducetheKawasakidiseaseandvascularstenosislateaneurysmformatio...