贫血影响川崎病患儿治疗的临床研究及机理探讨

Clinical study and mechanism discussion of anemia affecting the treatment of children with Kawasaki disease

目的:本研究以贫血为出发点对其在川崎病患儿治疗中的影响进行临床研究,并探讨其发病机理。方法:以2016年1月至2017年12月在我院进行住院治疗的120例年龄在1-4岁的典型川崎病患儿为研究对象,其中60例具有贫血临床特征的典型川崎病患儿作为观察组,另60例无贫血现象的典型川崎病患儿设置为对照组,采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)于发病第6 d、16 d分别对两组患者的巨噬细胞迁移抑制因子(macrophage migration inhibitory factor,MIF)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)三项指标进行检测,并进行统计学分析。结果:观察组与对照组在MIF、IL-6、TNF-α三项指标中差异均有统计学意义(P<0.05),且观察组患者三项指标水平明显高于对照组。结论:贫血加重了川崎病引发的体内各种细胞因子产生的级联放大效应,其中较为典型的MIF、IL-6、TNF-α等细胞因子大量产生,进一步造成更加严重的血管内皮损伤以及血管功能障碍。贫血在一定程度上反映了病情的轻重、影响川崎病患儿的康复,应给予广泛重视并积极进行精准治疗。

Objective:To investigate the effect of anemia on the treatment of children with Kawasaki disease and explore its pathogenesis.Methods:120 children with typical Kawasaki disease aged 1 to 4 years old who were hospitalized in our hospital from January 2016 to December 2017 were included in this study.Among them,60 children with Kawasaki disease with clinical features of anemia were selected as experimental group,and another 60 children were selected as control group.The concentration of macrophage migration inhibitory factor(MIF),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)in serum were measured by enzyme-linked immunosorbent assay(ELISA)on the 6th and 16th day after Kawasaki disease onset.Results:The serum levels of MIF,IL-6 and TNF-αin the experimental group were significantly higher than those in the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion:Anemia promotes the production of various cytokines in the body caused by Kawasaki disease.The typical cytokines such as MIF,IL-6 and TNF-αare produced in large quantities,which further causes more serious vascular endothelial damage and vascular function.To a certain extent,anemia reflects the severity of the disease and affects the rehabilitation of children with Kawasaki disease.It should be given extensive attention and actively treated with precision.