双嘧达莫辅助丙种球蛋白及阿司匹林治疗川崎病对患儿抗血小板聚集因子及疗效影响研究

Clinical analysis of different doses of gamma globulin intravenous injection combined with Aspirin in children with Kawasaki disease

目的:探讨双嘧达莫辅助丙种球蛋白(IVIG)及阿司匹林对川崎病(KD)患儿抗血小板聚集因子及疗效的影响。方法:将60例KD患儿随机均分为两组,对照组仅采用静脉滴注IVIG及口服阿司匹林进行治疗;观察组患儿在此基础上加服双嘧达莫进行治疗。记录两组患儿住院时间及临床症状消退时间;对比两组患儿治疗前后抗血小板聚集相关影响因子[血小板计数(PLT)、白细胞计数(WBC)、红细胞沉降率(ESR)]水平变化情况;比较两组患儿出现冠状动脉损伤状况及治疗有效率。结果:与对照组相比,观察组患儿住院时间、临床症状消退时间均明显缩短,冠状动脉损伤发生人数明显减少,治疗总有效率明显提高(P<0.05)。经治疗,两组患儿抗血小板聚集相关因子PLT、WBC、ESR水平均明显下降;且观察组患儿上述因子水平均明显优于对照组(P<0.05)。结论:双嘧达莫辅助IVIG及阿司匹林治疗KD可有效抑制血小板聚集,改善患儿免疫功能,缓解临床症状,降低冠状动脉损伤发生率,提高治疗效率。

Objective:To analyze the clinical effect of different doses of gamma globulin(IVIG)combined with Aspirin in the treatment of childhood Kawasaki disease(KD).Methods:45 patiences with KD were divided into three groups randomly.The cases of group A were treated with 400 mg/(kg·d)IVIG for 5 days,and group B received single dose of 1 g/(kg·d)for 2 days,and group C received single-dose of 2 g/(kg·d).The children of three groups were treated with aspirin.The hospitalization time and clinical symptoms subsided time was recorded in detail of all children,the levers of platelet count(PLT),white blood cell count(WBC),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)four inflammatory changes were recorded before and after treatment of tree groups;and the coronary artery injury and the treatment of efficiency were recorded with each group.Results:Compared with group A,the hospitalization time and clinical symptoms subsided time of group B and group C were both significantly shortened,and the four inflammatory indexes were significantly better than group A(P <0.05),but there was no significant difference betweeen group B and group C in the hospitalization time,clinical symptoms subsided time and the four inflammatory indexes(P>0.05).The incidence rate of coronary artery injury in group C was significantly lower than that in group A(P<0.05),and there was no significant difference of the coronary artery injury incidence rate between group B and group A,group B and group C(P>0.05).There was no significant difference in the total effective rate between group B and group C(P >0.05),but there was a significant difference between group B and group A,group C and group A(P<0.05).Conclusion:High-dose IVIG combined with Aspirin in children with Kawasaki disease treatment has significant effect,can effectively reduce hospitalization and clinical symptoms subsided time,inhibit the release of inflammatory cytokines,reduce the incidence of coronary artery injury.