影响儿童川崎病血小板变化的相关因素分析

Influencing Factors for Platelet in Children with Kawasaki Disease

目的:通过研究影响川崎病患儿血小板变化的相关因素,探讨川崎病患儿血小板水平升高的机制。方法:将36例川崎病患儿根据病程分为急性期组和恢复期组,同时纳入正常儿童23例作为对照组。测定三组儿童血小板(PLT)计数、平均血小板体积(MPV)、血小板分布宽度(PDW)、血清血小板生成素(TPO)水平、白细胞介素-1β(IL-1β)水平及血小板反应蛋白1(TSP-1)水平,比较三组患儿各指标的相关性。结果:川崎病患儿急性期组PLT计数升高,但与对照组比较差异无统计学意义(P>0.05);恢复期组PLT计数升高更明显,与急性期组和对照组比较差异有统计学意义(P<0.05)。急性期组MPV与对照组比较明显升高(P<0.05),恢复期组患儿MPV下降至正常水平,与对照组比较差异无统计学意义(P>0.05)。急性期组、恢复期组PDW均无显著变化(P>0.05)。急性期组患儿血清TPO、IL-1β和TSP-1水平明显高于恢复期组和对照组,组间比较差异有统计学意义(P<0.05);恢复期组TPO、IL-1β、TSP-1水平与急性期组比较均明显下降(P<0.05),TPO和TSP-1水平与对照组比较差异无统计学意义(P>0.05),而IL-1β水平仍高于对照组(P<0.05)。结论:川崎病患儿恢复期PLT计数升高可能与急性期血清细胞因子TPO、IL-1β及TSP-1水平有关。

Objective： To investigate mechanism of platelet elevated in children with Kawasaki disease,through the effect of influencing factors for platelet. Methods： Thirty six children with Kawasaki disease were divided into acute group and convalescent group,while 23 cases of normal children were included as control group. Count of platelet（ PLT）,mean platelet volume（ MPV）,platelet distribution width（ PDW）,level of serum thrombopoietin（ TPO）,interleukin-1β（ IL-1β） and thrombospondin 1（ TSP-1）were measured and compared among three groups. Results： The count of PLT was increased in the acute group,but the difference was not statistically significant compared with control group（ P0.05）. The count of PLT increased more significantly in convalescent group compared with acute group and control group（ P 0.05）. MPV in acute group was significantly higher than control group（ P 0.05）,MPV in convalescent group decreased to normal level,there was no significant statistical difference between convalescent group and control group（ P0.05）. There were no significant changes of PDW in acute group and convalescence group（ P 0.05）. TPO,IL-1βand TSP-1 levels in acute group were significantly higher than those of convalescence group and control group（ P0.05）. In convalescent group,TPO,IL-1β,TSP-1 levels were significantly decreased compared with acute group（ P 0. 05）,and there were no significant difference in TPO and TSP-1 compared with control group（ P 0. 05）,while IL-1β still higher than control group（ P 0. 05）.Conclusion： The count of PLT increase in convalescence phase of children with Kawasaki disease may be associated with TPO,IL-1βand TSP-1 in acute phase.