阿司匹林不同减量方案联合丙种球蛋白治疗小儿川崎病的效果及对血小板活性因子、心功能标志物的影响

Effect of different reduction regimens of aspirin combined with gamma globulin in the treatment of Kawasaki disease in children and its influences on platelet active factors and cardiac function markers

目的探讨阿司匹林不同减量方案联合丙种球蛋白治疗小儿川崎病的效果及对血小板活性因子、心功能标志物的影响。方法选取2018年2月至2021年12月收治的50例小儿川崎病患儿为研究对象,按照随机数字表法将其分为对照组与观察组,各25例。对照组采用阿司匹林直接减量联合丙种球蛋白治疗,观察组采用阿司匹林逐渐减量联合丙种球蛋白治疗。比较两组的治疗效果。结果两组的治疗总有效率比较,差异无统计学意义(P>0.05)。治疗后,两组的血小板活化因子(PAF)、血小板反应蛋白-1(TSP-1)水平均低于治疗前(P<0.05);治疗后,观察组的TSP-1水平低于对照组(P<0.05)。治疗后,两组的心型脂肪酸结合蛋白(H-FABP)、脑钠肽(BNP)水平均降低,且观察组低于对照组(P<0.05)。观察组的不良反应总发生率低于对照组(P<0.05)。结论阿司匹林逐渐减量与直接减量联合丙种球蛋白治疗小儿川崎病均有满意效果,但逐渐减量方案对心功能保护作用更好,也能减少不良反应,可作为首选方案。

Objective To explore the effect of different reduction regimens of aspirin combined with gamma globulin in the treatment of Kawasaki disease in children and its influences on platelet active factors and cardiac function markers.Methods A total of 50 children with Kawasaki disease admitted from February 2018 to December 2021 were selected as the research objects.According to the random number table method,the children were divided into control group and observation group,with 25 cases in each group.The control group was treated with direct reduction of aspirin combined with gamma globulin,and the observation group was treated with gradual reduction of aspirin combined with gamma globulin.The therapeutic effects of the two groups were compared.Results There was no significant difference in the total effective rate between the two groups(P>0.05).After treatment,the levels of platelet activating factor(PAF)and thrombospondin-1(TSP-1)in the two groups were lower than those before treatment(P<0.05);after treatment,the level of TSP-1 in the observation group was lower than that in the control group(P<0.05).After treatment,the levels of heart-type fatty acid-binding protein(H-FABP)and brain natriuretic peptide(BNP)in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion Gradual reduction and direct reduction of aspirin combined with gamma globulin in the treatment of Kawasaki disease in children have satisfactory results,but the gradual reduction scheme has better cardiac function protection and can also reduce adverse reactions,which can be used as the first choice.