双嘧达莫联合静脉注射人免疫球蛋白和阿司匹林治疗对川崎病患儿凝血功能、免疫功能及预后的影响  

Effects of Dipyridamole Combined with Intravenous Immunoglobulin and Aspirin on Coagulation Function,Immune Function and Prognosis in Children with Kawasaki Disease

作　　者：冯双双 田赛 矫岩[1] FENG Shuang-shuang;TIAN Sai;JIAO Yan(Department of Pediatrics,Qingdao Municipal Hospital,Qingdao,Shandong 266000,China)

机构地区：[1]青岛市市立医院儿科,山东青岛266000

出　　处：《临床误诊误治》2022年第6期44-47,共4页Clinical Misdiagnosis & Mistherapy

基　　金：山东省自然科学基金面上项目(ZR201703030435)。

摘　　要：目的探讨双嘧达莫联合静脉注射人免疫球蛋白(IVIG)和阿司匹林治疗对川崎病患儿凝血功能、免疫功能及预后的影响。方法收集2017年6月—2021年12月收治96例川崎病患儿的临床资料。按不同治疗方法将纳入患儿分为对照组47例和研究组49例,对照组给予IVIG和阿司匹林治疗,研究组给予双嘧达莫联合IVIG和阿司匹林治疗。比较两组临床症状缓解时间、免疫功能指标、凝血功能指标、冠状动脉损伤程度及不良反应发生情况。结果研究组发热、躯干红斑、结膜充血、颈淋巴结肿胀、口腔黏膜弥漫性充血缓解时间均较对照组短(P<0.05)。治疗后,两组CD8+均较治疗前升高,CD4+、CD4+/CD8+及血浆纤维蛋白原较治疗前降低,且研究组上述指标升高或降低程度均大于对照组(P<0.05)。研究组冠状动脉损伤总发生率低于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论双嘧达莫联合IVIG和阿司匹林治疗KD患儿可缩短临床症状缓解时间,改善凝血功能和免疫功能,降低冠状动脉损伤程度,且安全性高。Objective To investigate the effect of Dipyridamole combined with intravenous immunoglobulin(IVIG)and Aspirin on coagulation function,immune function and prognosis in children with Kawasaki disease(KD).Methods The clinical data of 96 children with KD admitted from June 2017 to December 2021 were collected.According to different treatment methods,the included children were divided into the control group(n=47)and the research group(n=49).The control group was given IVIG and Aspirin treatment,and the research group was given Dipyridamole combined with IVIG and Aspirin treatment.The remission time of clinical symptoms,immune function indexes,coagulation function indexes,degree of coronary artery injury and occurrence of adverse reactions were compared between the two groups.Results The remission time of fever,trunk erythema,conjunctival congestion,cervical lymph node swelling,and diffuse congestion of oral mucosa in the research group was shorter than that in the control group(P<0.05).After treatment,the levels of CD8+in both groups were higher than those before treatment,while CD4+,CD4+/CD8+and plasma fibrinogen were lower than those before treatment,and the increase or decrease of the above indexes in the research group was greater than that in the control group(P<0.05).The total incidence of coronary artery injury in the research group was significantly lower than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Dipyridamole combined with IVIG and Aspirin in the treatment of children with KD can shorten the remission time of clinical symptom,improve coagulation function and immune function,reduce the degree of coronary artery damage,and has good safety.

关 键 词：川崎病 双嘧达莫 人免疫球蛋白 阿司匹林 T淋巴细胞亚群 纤维蛋白原 

分 类 号：R725.5[医药卫生—儿科]