Research On Changes Of Serum TPO And TSP-1in Children With Kawasaki Disease And Its Significance

Objectives:To observe the distribution of serum thrombopoietin (TPO), thrombospondin-1(TSP-1), platelet total (PLT) and platelet parameters in children with Kawasaki disease (KD) and children in the control group, to explore deeply the law of changes of platelets, and relation between TPO, TSP-1and changes of platelets, its potential mechanisms, in order to lay the foundation for the research on mechanisms of KD.Methods:Serum TPO and serum TSP-1were measured by Enzyme-linked immunosorbent assay(ELISA), PLT and platelet parameters were measured by Automatic Hematology Analyzer in32cases of KD inpatients of pediatric department during September1st,2011and December31st,2012,30cases of children in similar ages in the control group were measured the same indicators during the same period. The differences between acute, sub-acute and convalescent phase in children with KD and the control group respectively, the trend of changes of these indicators among different phases, the correlation between serum TPO and serum TSP-1, between serum TPO and PLT, between serum TSP-1and PLT were analyzed.Results:(1) Compared with the control group, the level of serum TPO, serum TSP-1, PLT, PCT, PDW, MPV, PLCR(P<0.05) increased significantly in acute KD children; The level of serum TPO, serum TSP-1, PLT, PCT, PDW, MPV(P<0.05) were increased obviously in sub-acute children with KD; There was increasing significance in PLT, PCT(P<0.05), but no statistical significance was showed in other indicators.(2) The level of serum TPO and serum TSP-1was highest in acute phase and decreased little by little; PLT reached the peak in sub-acute phase; The activity of platelet reached the strongest in acute children with KD and decreased then. Compared with sub-acute phase, the level of serum TPO, serum TSP-1, PDW, MPV, PLCR(P<0.05) were increased, however, it decreased in PLT and PCT (P<0.01); Compared with that of convalescent children with KD, in acute phase, the level of serum TPO, serum TSP-1, PDW, MPV, PLCR(P<0.05) significantly increased, three was obvious changes in PLT and PCT; Compared with that of convalescent children with KD, in sub-acute phase, serum TPO, serum TSP-1, PLT, PCT, MPV(P<0.05) increased, no obvious significance was showed in PDW and PLCR.(3) Correlation analysis:There was no correlation between the level of serum TPO and TSP-1in acute and convalescent phase, positive correlation was showed in sub-acute KD children (r=0.418, P<0.05); There was no correlation between the level of serum TPO and PLT in acute, sub-acute and convalescent phase; Similarly, there was no correlation between the level of serum TSP-1and PLT in acute, sub-acute and convalescent phase.Conclusions:(1) TPO functions as an acute phase reactant, the level of it is regulated by several factors in spite of the number of platelets.(2) The number of platelets reaches highest in sub-acute children with KD, as secondary reaction, lagging behind the peak phase of serum TPO.(3)The activity of platelet reaches the strongest in acute children with KD, the level of serum TSP-1was related to the activity of the platelet, it can be used as an indicator to evaluate the extent to which the activity of platelet reaches.