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【Objective】 Kawasaki disease is a systemic inflammatory disease of the small arteries as the main pathological changes of acute febrile rash illness. The disease has replaced rheumatic fever as the leading cause of acquired heart disease in China and the majority of countries around the world children. Kawasaki disease cause of coronary expansion mechanism has not yet been clarified. Intravenous infusion of gamma globulin has become an effective treatment for reducing coronary expansion, but 10% of patients have no response to gamma globulin. Circulating endothelial cells in recent years, S100A12, RAGE has attracted the attention of the majority of scholars. To clear relationship between circulating endothelial cells, RAGE with Kawasaki disease, we study in the acute phase of Kawasaki disease blood circulating endothelial cells and circulating endothelial cells express RAGE, subacute phase, convalescent level changes of both role in the pathogenesis of Kawasaki disease and predicting children gamma globulin reaction and coronary dilatation value. Materials and methods Experimental groups 1.1 Control group: 38 patients, with no recent history of infection for healthy children at the Children Hospital of Zhejiang University School of Medicine in December 2008 - July 2009 examination no positive signs, did not receive any medication and blood transfusion therapy. Auxiliary examination: blood count, liver and kidney of cardiac function, electrolytes, ECG, X-ray chest radiographs were normal. 1.2 Kawasaki disease: a total of 79 cases hospitalized at Children Hospital of Zhejiang University School of Medicine in December 2008 - July 2009, diagnosed with Kawasaki disease in children after IVIG treatment. Which IVIG nonresponders group of five cases, 11 cases of coronary artery dilatation group. 2, flow measurement: detected using monoclonal antibodies and flow cytometry binding circulating endothelial cell / monocyte RAGE positive rate, RAGE fluorescence intensity. [Results] 1, circulating endothelial cells in acute phase of Kawasaki disease / monocyte cell RAGE positive rate, RAGE fluorescence intensity were 1.45 ± 0.54,26.66 ± 10.16,31.29 ± 11.55; subacute phase circulating endothelial cell / monocyte cells RAGE positive rate, RAGE fluorescence intensity were 1.41 ± 0.49,23.87 ± 6.36,30.04 ± 8.95: convalescent circulating endothelial cell / monocyte cell RAGE positive rate, RAGE fluorescence intensity were 1.39 ± 0.49,25.17 ± 9.93,28.98 ± 8.52. Control group circulating endothelial cell / monocyte cell RAGE positive rate, RAGE fluorescence intensity were 0.95 ± 0.39,17.71 ± 4.52,21.47 ± 4.26. Kawasaki disease group compared with the control group, the difference was statistically significant (P <0.05). 2, IVIG acute phase response group circulating endothelial cell / monocyte RAGE positive rate, RAGE fluorescence intensity were 1.38 ± 0.65,24.42 ± 12.87,26.58 ± 7.75; the subacute phase circulating endothelial cell / monocyte, RAGE positive rate, RAGE fluorescence intensity were 1.58 ± 0.58,26.50 ± 6.81,33.41 ± 13.84; convalescent circulating endothelial cell / monocyte cell RAGE positive rate, RAGE fluorescence intensity were 1.23 ± 0.45,31.97 ± 15.31,38.67 ± 12.34. IVIG reaction group and the control group, the difference was significant (P <0.05). The acute phase of Coronary Dilatation group circulating endothelial cell / monocyte cell RAGE positive rate, RAGE fluorescence intensity were 1.40 ± 0.49,26.71 ± 6.80,27.56 ± 6.17; subacute phase circulating endothelial cells / monocytes, RAGE positive rate RAGE fluorescence intensity were 1.38 ± 0.59,26.61 ± 6.84,27.53 ± 8.30; convalescent circulating endothelial cell / monocyte cell RAGE positive rate, RAGE fluorescence intensity were 1.25 ± 0.50,28.41 ± 13.64,29.73 ± 8.99. Coronary artery group and the control group, the difference was significant (P <0.05). IVIG sensitive group acute phase circulating endothelial cell / monocyte cell RAGE positive rate, RAGE fluorescence intensity were 1.43 ± 0.54,26.15 ± 9.93,36.12 ± 43.37; subacute phase circulating endothelial cell / monocyte cells, RAGE positive rate RAGE fluorescence intensity were 1.40 ± 0.48,23.65 ± 7.82,29.91 ± 8.65; convalescent circulating endothelial cell / monocyte cell RAGE positive rate, RAGE fluorescence intensity were 1.40 ± 0.48,24.14 ± 8.80; 27.62 ± 7.04. IVIG non-response group with IVIG compared to the sensitive group difference was not statistically significant (P> 0.05). 5, the acute phase of coronary expansion group circulating endothelial cell / monocyte cell RAGE positive rate, RAGE fluorescence intensity were 1.43 ± 0.54,26.01 ± 10.21,36.99 ± 45.34; subacute phase circulating endothelial cell / monocyte, RAGE positive rate, RAGE fluorescence intensity were 1.44 ± 0.49,23.62 ± 7.98,30.21 ± 8.86; convalescent circulating endothelial cell / monocyte cell RAGE positive rate, RAGE fluorescence intensity were 1.38 ± 0.50,23.45 ± 8.12,27.80 ± 7.44 . Of coronary dilatation group with coronary no dilation group compared with no significant differences (P> 0.05). [Conclusion] of CECs, RAGE two in the entire course of Kawasaki disease have a significant increase, both played an important role in the pathogenesis of Kawasaki disease, but its level of children still can not predict whether the gamma globulin-free reaction as well as coronary dilatation.
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