川崎病患儿血清总免疫球蛋白E及嗜酸性粒细胞的变化及意义

An observational study on peripheral blood eosinophils and serum total IgE in children with Kawasaki disease

目的:探讨川崎病(Kawasaki disease,KD)患儿在急性期及恢复期总免疫球蛋白E(immunoglobulin E,IgE)水平、嗜酸性粒细胞的变化及意义。方法:对2015年10月至2019年1月我院儿科收治的65例KD患儿临床资料进行回顾性分析,作为KD组,分别在急性期(起病5~10d)和恢复期(起病1个月)检测血清总IgE含量、嗜酸性粒细胞计数和百分比,进行统计分析;纳入健康对照患儿22例作为对照组。统计患病前及患病后1年内KD患儿患过敏性疾病(包括过敏性鼻炎、哮喘、过敏性咳嗽、变应性皮炎等)的情况。结果:KD组恢复期血清总IgE水平[282.6(94.2,454.5)IU/mL]、嗜酸性粒细胞计数[0.43(0.23,0.63)×10^(9)]以及嗜酸性粒细胞百分比[4.7(2.4,6.8)%],均高于急性期血清总IgE水平[160.7(15.4,302.0)IU/mL]、嗜酸性粒细胞计数[0.3(0.1,0.6)×10^(9)]及百分比[3.3(1.6,5.1)%],差异有统计学意义(P<0.05)。KD组急性期、恢复期各数据,均高于对照组血清总IgE水平[42.2(18.9,62.2)IU/mL]、嗜酸性粒细胞计数[0.14(0.09,0.19)×10^(9)]及百分比[2.7(1.3,4.0)%],差异有统计学意义(P<0.05)。KD前患过敏性疾病的KD患儿3例,KD后1年内患过敏性疾病的患儿11例,较KD前增多,差异有统计学意义(P<0.05)。结论:KD患儿嗜酸性粒细胞、总IgE水平增高,在恢复期升高更为显著,这可能与KD患儿后续易患过敏性疾病有关。

Objective:To investigate the peripheral blood eosinophils(EOS)and serum total immunoglobulin E(IgE)in children with Kawasaki disease(KD).Methods:A total of 65 patients with KD were evaluated.Both in acute phase and remission phase,We determined the level of serum total IgE,the eosinophils counts from the complete blood count in two study groups.Another 22 children who were healthy were taken as control health group.Results:In KD group,the level of serum total IgE[282.6(94.2,454.5)IU/mL],the eosinophils counts[0.43(0.23,0.63)×10^(9)]and the percentage of eosinophils[4.7(2.4,6.8)%]in remission phase were higher compared to acute phase[160.7(15.4,302.0)IU/mL,0.34(0.13,0.57)×10^(9),3.3(1.6,5.1)%],and P was small than 0.05.Also,the level of serum total IgE,the eosinophils counts and the percentage of eosinophils in KD group were statistically significant higher compared to control health group[42.2(18.9,62.2)IU/mL,0.1(0.09,0.19)×10^(9),2.7(1.3,4.0)%,P<0.05].Children with allergic disease after KD(11)were more than that before KD(3).Conclusions:The counts and rates of EOS were found significantly higher in remission phase compared to acute phase.The development of Kawasaki disease is closely related to the allergic diseases.