Abstract:

Objective   To observe the change of different forms of osteocalcin in children with Kawasaki disease（KD） and explore the relationship of osteocalcin with Kawasaki Disease. Methods   A total of 34 hospitalized children with Kawasaki disease between March 2015 and December 2015 were selected，and all of them came from Children’s Hospital of Shanxi Province.  According to the course，each child was divided into acute stage and subacute stage. At the same time，20 healthy children were chosen as the control. The levels of plasma N-MID osteocalcin and undercarboxylated osteocalcin were measured. Erythrocyte sedimentation rate（ESR） and C-reactive protein（CRP） were analyzed and the changes of osteocalcin，ESR and CRP were compared. Results    The levels of plasma undercarboxylated osteocalcin in KD patients were significantly lower than control［（14.2±0.3） ng/mL for acute stage，（14.4±0.3） μg/L for subacute stage，（16.3±0.4） μg/L for control，P＜0.01）］. The levels of plasma N-MID osteocalcin in KD patients did not differ from control［（27.3±0.5） μg/L for acute stage，（27.5±0.5） μg/L for subacute stage，（28.3±0.8） μg/L for control，all P＞0.05）］. The levels of CRP in acute stage were significantly higher than in subacute stage［（79.1±10.3）mg/L for acute stage vs.（2.7±0.5） mg/L for subacute stage，P＜0.001）］. The levels of ESR in acute stage were higher than in subacute stage［（58.5±4.1） mm/h for acute stage vs. （49.1±4.7） mm/h for subacute stage，P＜0.05）］. In acute stage， the correlation analysis showed that the levels of plasma undercarboxylated osteocalcin were negatively correlated with CRP and ESR（P＜0.05）. Conclusion    Plasma undercarboxylated osteocalcin might participate in the pathogenesis and development of KD. The measurement of plasma undercarboxylated osteocalcin could be valuable in the diagnosis of KD in children.

Key words: Kawasaki disease, undercarboxylated osteocalcin, N-MID osteocalcin, erythrocyte sedimentation rate, C-reactive protein

摘要：

目的    观察不同形式的骨钙素在儿童川崎病中的变化，研究其与川崎病的关系。方法    选取2015年3月至12月在山西省儿童医院心血管与风湿免疫科确诊为川崎病的34例住院患儿，根据病程，每例患儿被分为急性期、亚急性期；对照组20例，检测各组血浆中N端中段骨钙素、羧化不全骨钙素水平，同时分析血沉（ESR）和 C反应蛋白（CRP），比较骨钙素和ESR、CRP在川崎病中的变化。结果    患儿在急性期和亚急性期的血浆羧化不全骨钙素的水平均明显低于对照组［急性期为（14.2±0.3） μg/L，亚急性期为（14.4±0.3） μg/L，对照组为（16.3±0.4） μg/L，P均＜0.01］。与对照组相比，患儿血浆N端中段骨钙素的水平无明显变化［急性期为（27.3±0.5） μg/L，亚急性期为（27.5±0.5） μg/L，对照组为（28.3±0.8） μg/L，P均＞0.05］。急性期的患儿CRP水平明显高于亚急性期［急性期为（79.1±10.3） mg/L vs.亚急性期为（2.7±0.5） mg/L，P＜0.001］。急性期的患儿ESR水平高于亚急性期［急性期为（58.5±4.1） mm/h vs.亚急性期为（49.1±4.7） mm/h，P＜0.05］。急性期的患儿血浆羧化不全骨钙素与ESR、CRP均呈负相关（P均＜0.05）。结论    血浆中羧化不全的骨钙素有可能参与了川崎病的发生、发展，测定其水平有助于儿童川崎病的诊断。

关键词: 川崎病, 羧化不全的骨钙素, N端中段骨钙素, 血沉, C反应蛋白