川崎病中的丙种球蛋白使用时机及对患儿肿瘤坏死因子α的影响评价

Evaluation of the Timing of Gamma Globulin Use in Kawasaki Disease and Its Effect on Tumor Necrosis Factor Alpha in Children

目的观察并探讨川崎病中的丙种球蛋白使用时机及对患儿肿瘤坏死因子α的影响。。方法选取2013年11月--2018年11月期间来该院就诊的64例川崎病患儿,随机按患儿就诊顺序分为对照组与实验组,各32例,实验组患儿发病早期应用丙种球蛋白,对照组患儿发病后应用丙种球蛋白治疗,对两组患儿治疗前后NE、PLT、WBC、血清炎性细胞因子、血清IgG1、IgG2、IgG4水平以及症状改善情况进行评价。结果实验组与对照组患儿治疗前CRP、NE、PLT、WBC、IL-6,其中对照组IL-6从之前的(18.52±3.05)ng/L改善为治疗后的(15.48±2.41)ng/L,实验组对应的指标从(18.61±3.14)ng/L改善为(9.74±3.42)ng/L,TNF-α指标、血清IgG1、IgG2、IgG4水平比较差异无统计学意义(P>0.05)。实验组患儿治疗后CRP、NE、PLT、WBC、IL-6、TNF-α指标、血清IgG1、IgG2、IgG4水平与对照组结果比较均显著降低,实验组患儿住院时间、退热时间、粘膜充血消退时间以及手足肿胀消除时间均显著短于对照组,差异有统计学意义(P<0.05)。结论在川崎病患儿临床治疗中早期应用丙种球蛋白具有确切疗效,值得推广应用。

Objective To observe and explore the timing of gamma globulin use in Kawasaki disease and its effect on tumor necrosis factor alpha.Methods A total of 64 children with Kawasaki disease who were admitted to our hospital from November 2013 to November 2018 were randomly divided into the control group and the experimental group.The number of patients was the same in 32 cases.Early application of gamma globulin,gamma globulin treatment in the control group,evaluation of NE,PLT,WBC,serum inflammatory cytokines,serum IgGl,IgG2,IgG4 levels and symptom improvement before and after treatment in the two groups of children.Results The children in the experimental group and the control group received CRP,NE,PLT,WBC and IL-6 before treatment.The IL-6 of the control group improved from(18.52±3.05)ng/L before the treatment to(15.48±2.41)ng/L after treatment.The corresponding index of the experimental group was(18.61±3.14)ng/L,improved to(9.74±3.42)ng/L.There were no statistically significant differences in TNF-α index,serum IgG1,IgG2,and IgG4 levels(P>0.05).The levels of CRP,NE,PLT,WBC,IL-6,TNF-α,ser-um IgG1,IgG2,and IgG4 in the experimental group were significantly lower than those in the control group.The hospital stay,fever time,and mucosal congestion remission time and hand and foot swelling elimination time in the experimental group were significantly shorter than the control group,the difference was statistically significant(P<0.05).Conclusion The early application of gamma globulin in the clinical treatment of children with Kawasaki disease has a definite curative effect and is worthy of popularization and application.