高剂量丙种球蛋白联合双嘧达莫改善川崎病患儿凝血功能及炎症因子的效果  

The Effects of High-Dose Immunoglobulin Combined with Dipyridamole on Coagulation Function and Inflammatory Factors in Children with Kawasaki Disease

作　　者：高冬燕 GAO Dongyan(Fujian Fuzhou Children's Hospital,Fuzhou 350000,China)

机构地区：[1]福建省福州儿童医院,福州350000

出　　处：《中国医药指南》2024年第11期94-97,共4页Guide of China Medicine

基　　金：福州市“十四五”临床专科培强培优培育建设项目(20220101)。

摘　　要：目的探究高剂量丙种球蛋白联合双嘧达莫治疗对川崎病患儿凝血功能、炎症因子及免疫的影响。方法选取2022年3月至2023年10月福建省福州儿童医院就诊的86例川崎病患儿,根据治疗方法不同分为观察组与治疗组。观察组(43例)给予高剂量丙种球蛋白联合双嘧达莫进行治疗,对照组(43例)按照常规方案进行治疗。两组患儿均持续进行2 d治疗。分别对患儿炎症因子、凝血功能、免疫系统水平在治疗前以及治疗后进行检测与对比。结果患儿凝血功能水平进行检测,在治疗前凝血四项未表现统计学差异(均P>0.05),而在治疗后纤维蛋白原水平观察组低于对照组(P<0.05),活化部分凝血活酶时间、凝血酶原时间、凝血酶时间水平观察组较高(P<0.05)。白细胞介素4(IL-4)、白细胞介素12(IL-12)、干扰素γ(γ-IFN)水平治疗前,两组患儿无明显差异(均P>0.05),治疗后观察组较对照组低(P<0.05)。患者治疗前后免疫功能水平对比,治疗前各NK细胞、CD4^(+)、CD8^(+)指标无差异(均P>0.05),治疗后观察组改善更为显著,且观察组各项均优于对照组(P<0.05)。患儿热症状、躯干红斑、黏膜弥漫性充血、颈淋巴结肿胀改善时间对比,观察组均短于对照组(均P<0.05)。结论在对川崎病患儿治疗时按照高剂量丙种球蛋白联合双嘧达莫进行治疗,可以改善患儿凝血功能,降低炎症因子水平,提升免疫水平,迅速改善患儿各方面症状。Objective To investigate the effects of high-dose immunoglobulin combined with dipyridamole treatment on coagulation function,inflammatory factors,and immunity in children with Kawasaki disease.Methods A total of 86 children with Kawasaki disease who visited Fuzhou Children's Hospital in Fujian Province from March 2022 to October 2023 were selected and randomly divided into an observation group and a control group using a number table method.The observation group(43 cases)was treated with high-dose immunoglobulin combined with dipyridamole,while the control group(43 cases)was treated according to the conventional regimen.Both groups of children underwent continuous treatment for 2 days.Detect and compare the inflammatory factors,coagulation function,and immune system levels of the children before and after treatment.Results The coagulation function level of the children was tested,and there was no statistically significant difference in the four coagulation items before treatment(all P>0.05).However,after treatment,the fibrinogen level in the observation group was lower than that in the control group(P<0.05),while the activated partial thromboplastin time,prothrombin time,and thrombin time were higher in the observation group(P<0.05).Interleukin-4,interleukin-12,interferon-γbefore horizontal treatment,there was no significant difference between the two groups of children(all P>0.05),and after treatment,the observation group was lower than the control group(P<0.05).Comparing the immune function levels of patients before and after treatment,there was no difference in NK cells,CD4^(+),and CD8^(+) indicators before treatment(all P>0.05).The observation group showed more significant improvement after treatment,and the observation group was better than the control group in all categories(P<0.05).Compared with the control group,the observation group showed shorter improvement time in terms of fever symptoms,trunk erythema,diffuse mucosal congestion,and neck lymph node swelling in the affected children(all P<0.05).Concl

关 键 词：川崎病 高剂量丙种球蛋白 双嘧达莫 凝血功能 炎症因子 

分 类 号：R725.1[医药卫生—儿科]