大剂量丙种球蛋白联合阿司匹林治疗小儿川崎病的临床价值

Clinical Value of High-dose Gammaglobulin Combined with Aspirin in the Treatment of Pediatric Kawasaki Disease

目的:研究阿司匹林联合大剂量丙种球蛋白治疗川崎病的临床价值。方法:选取2019年2月—2022年12月广州市花都区妇幼保健院收治的川崎病患儿92例为研究对象,依据随机数字表法分为研究组与对照组,各46例。对照组给予阿司匹林联合常规剂量丙种球蛋白治疗,研究组给予阿司匹林联合大剂量丙种球蛋白治疗。比较两组实验室指标[降钙素原(PCT)、血小板计数(PLT)、白细胞计数(WBC)、C反应蛋白(CRP)]、T淋巴细胞亚群水平、冠状动脉病变发生率。结果:治疗前,两组PCT、PLT、WBC、CRP水平比较,差异无统计学意义(P>0.05);治疗后,两组PCT、PLT、WBC、CRP水平低于治疗前,研究组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+)比较,差异无统计学意义(P>0.05);治疗后,两组CD4^(+)、CD4^(+)/CD8^(+)水平降低,研究组低于对照组,CD8^(+)水平升高,研究组高于对照组,差异有统计学意义(P<0.05)。研究组冠状动脉病变发生率低于对照组,差异有统计学意义(P=0.036)。结论:阿司匹林联合大剂量丙种球蛋白治疗小儿川崎病的效果显著,能够改善临床症状,降低炎性反应水平,减轻T淋巴细胞亚群失衡,预防冠状动脉病变的发生。

Objective:To study the clinical value of aspirin combined with high-dose gammaglobulin in the treatment of Kawasaki disease.Methods:Ninety-two cases of children with Kawasaki disease admitted to Guangzhou Huadu District Maternal and Child Health Hospital from February 2019 to December 2022 were selected as the study subjects,and were divided into the study group and the control group based on the randomized numerical table method,with forty-six cases in each group.The control group was treated with aspirin combined with regular-dose gammaglobulin,and the study group was treated with aspirin combined with high-dose gammaglobulin.Laboratory indexes[procalcitonin(PCT),platelet count(PLT),white blood cell count(WBC),C-reactive protein(CRP)],T-lymphocyte subpopulation levels,and incidence of coronary artery lesions were compared between the two groups.Results:Before treatment,there was no statistically significant difference in the levels of PCT,PLT,WBC,and CRP between the two groups(P>0.05);after treatment,the levels of PCT,PLT,WBC and CRP in the two groups were lower than those before treatment,and the study group was lower than the control group,and the difference was statistically significant(P<0.05).Before treatment,CD8^(+),CD4^(+),CD4^(+)/CD8^(+)were compared between the two groups,and the difference was not statistically significant(P>0.05);after treatment,the levels of CD4^(+),CD4^(+)/CD8^(+)in the two groups decreased,and the study group was lower than the control group,and the levels of CD8^(+)increased,and the study group was higher than the control group,and the difference was statistically significant(P<0.05).The incidence of coronary artery lesions was lower in the study group than in the control group,and the difference was statistically significant(P=0.036).Conclusion:Aspirin combined with high-dose gammaglobulin is effective in the treatment of pediatric Kawasaki disease,which can improve the clinical symptoms,reduce the level of inflammatory response,alleviate the imbalance of T-lymphocyte subpopulations,and prevent the occurrence of coronary artery lesions.