维生素D治疗川崎病的疗效及其对血清促炎因子的影响

Therapeutic Effect of Vitamin D on Kawasaki Disease and Its Effect on Serum Pro-inflammatory Factors

目的探究维生素D联合静脉用免疫球蛋白及阿司匹林对川崎病的疗效以及对血清促炎性细胞因子IL-21、IL-23及IL-27水平的影响。方法选取我院2018年1月~2019年5月治疗的60例急性川崎病患儿,随机分为对照组和观察组,各30例,对照组患儿给予静脉滴注丙种球蛋白,同时在饭后口服阿司匹林肠溶,观察组患儿在对照组基础上给予口服维生素D治疗。比较两组冠状动脉损害发生率、丙种球蛋白无反应比例、IVIG不良反应发生率、退热时间、治疗前后血白细胞、C反应蛋白、血沉、血小板、IL-21、IL-23及IL-27水平。结果观察组冠状动脉损害发生率、丙种球蛋白无反应比例、IVIG不良反应发生率、退热时间均低于对照组,差异具有统计学意义(P<0.05);治疗后观察组白细胞、C反应蛋白、血沉、血小板均低于对照组,差异具有统计学意义(P<0.05);治疗后两组血清IL-21、IL-23及IL-27水平均较治疗前下降,且观察组下降水平高于比对照组,差异具有统计学意义(P<0.05)。结论维生素D联合静脉用免疫球蛋白及阿司匹林在川崎病患儿治疗过程中,效果显著,有助于改善患儿血清指标,值得应用。

Objective To investigate the effects of vitamin D combined with intravenous immunoglobulin and aspirin on Kawasaki disease and the levels of serum proinflammatory cytokines IL-21,IL-23 and IL-27.Methods 60 patients with acute Kawasaki disease who were treated in our hospital from January 2018 to May 2019 were randomly divided into control group and observation group,30 cases in each group.The control group received intravenous infusion of gamma globulin.Oral aspirin was orally administered after meals,and the patients in the observation group were given oral vitamin D treatment on the basis of the control group.The incidence of coronary artery lesions,gamma globulin non-response ratio,IVIG adverse reaction rate,fever time,white blood cells,C-reactive protein,erythrocyte sedimentation rate,platelets,IL-21,IL-23 and IL-27 were compared between the two groups.Results The incidence of coronary artery lesions,gamma globulin non-response ratio,IVIG adverse reaction rate and fever time were lower in the observation group than in the control group,the difference was statistically significant(P<0.05).After treatment,the white blood cells and C-reactive protein were observed.The blood sedimentation and platelet counts were lower than the control group,the difference was statistically significant(P<0.05).After treatment,the serum levels of IL-21,IL-23 and IL-27 decreased,The decrease in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion Vitamin D combined with intravenous immunoglobulin and aspirin in the treatment of children with Kawasaki disease,the effect is significant,which helps to improve the serum index of children,it is worth applying.