完全川崎病和不完全川崎病的临床特点差异及丙种球蛋白联合阿司匹林的干预效果分析  

Difference of clinical characteristics between complete Kawasaki disease and incomplete Kawasaki disease and analysis of intervention effect of gamma globulin combined with aspirin

作　　者：商晓式 李建业 SHANG Xiaoshi;LI Jianye(Pingdingshan Maternal and Child Health Hospital,Pingdingshan 467000,China)

机构地区：[1]平顶山市妇幼保健院,平顶山467000

出　　处：《中国免疫学杂志》2025年第4期967-971,共5页Chinese Journal of Immunology

摘　　要：目的:研究完全川崎病及不完全川崎病的临床特点差异及丙种球蛋白联合阿司匹林的干预效果。方法:采取前瞻性研究,采用N=Z^(2)×σ^(2)/d^(2)进行样本量计算,以2017年11月至2022年10月于平顶山市妇幼保健院诊断并进行治疗的川崎病患者120例作为研究对象,其中完全川崎病患者54例,不完全川崎病患者66例,所有患者入组后均采取丙种球蛋白联合阿司匹林进行治疗,比较完全川崎病及不完全川崎病患者临床特征、实验室指标之间的差异,研究完全川崎病及不完全川崎病患者治疗前后的临床症状改善情况、免疫功能、炎症反应指标以及并发症之间的差异。结果:完全川崎病及不完全川崎病患者口唇改变、发热之间的差异无统计学意义(P>0.05),完全川崎病组患者发生肛周蜕皮、手足硬肿脱皮、颈部淋巴结肿大、皮疹、球结膜充血概率显著高于不完全川崎病患者(P<0.05);完全川崎病及不完全川崎病患者白细胞、血小板、C反应蛋白(CRP)、血沉、血红蛋白、天冬氨酸转移酶之间的差异无统计学意义(P>0.05);完全川崎病患者的退热时间、手足肿胀时间、颈部淋巴结消散时间、眼结膜充血概率时间显著短于不完全川崎病患者(P<0.05);经过治疗后,两组患者的CD4^(+)CD25^(+)Treg及Th17均显著下调,且完全川崎病患者的CD4^(+)CD25^(+)Treg及Th17显著低于不完全川崎病患者(P<0.05);两组患者的CRP、IL-6及TNF-α均显著下调,且完全川崎病患者的CRP、IL-6及TNF-α水平显著低于不完全川崎病患者(P<0.05);完全川崎病患者的冠状动脉左主干、冠状动脉右干、冠状动脉左前降支、冠状动脉左回旋支的血管直径降低情况显著高于不完全川崎病患者(P<0.05)。结论:完全川崎病和不完全川崎病的临床特点差异主要以临床表现、血液指标以及临床改善情况为主,在对完全川崎病患者的治疗中,丙种球蛋白联合阿司匹林可�Objective:To investigate the difference of clinical characteristics between complete Kawasaki disease and incomplete Kawasaki disease and the intervention effect of gamma globulin combined with aspirin.Methods:Using prospective studies,N=Z^(2)×σ^(2)/d^(2)was used to calculate the sample size.A total of 120 patients with Kawasaki disease diagnosed and treated in Pingdingshan Maternal and Child Health Hospital from November 2017 to October 2022 were selected as research objects,including 54 patients with complete Kawasaki disease and 66 patients with incomplete Kawasaki disease.All patients were treated with gamma globulin combined with aspirin,clinical features and laboratory indexes of patients with complete Kawasaki disease and those with incomplete Kawasaki disease were compared,and the differences in clinical symptom improvement,immune function,inflammatory response indexes and complications before and after treatment of patients with complete Kawasaki disease and incomplete Kawasaki disease were studied.Results:There was no statistical significance in lip changes and fever between complete Kawasaki disease patients and incomplete Kawasaki disease patients(P>0.05).Perianal molting,hand and foot swelling and peeling,cervical lymph node enlargement,rash and conjunctival congestion in complete Kawasaki disease group were significantly higher than those in incomplete Kawasaki disease patients(P<0.05);there was no statistical significance in leukocytes,platelets,C-reactive protein(CRP),erythrocyte deposition,hemoglobin and aspartic transferase in patients with complete Kawasaki disease and incomplete Kawasaki disease(P>0.05);time of fever reduction,hand and foot swelling,neck lymph node dissipation and conjunctival congestion in complete Kawasaki disease patients were significantly shorter than those in incomplete Kawasaki disease group(P<0.05).After treatment,CD4^(+)CD25^(+)Treg and Th17 in two groups were significantly decreased,and CD4^(+)CD25^(+)Treg and Th17 in complete Kawasaki disease were significantly lo

关 键 词：川崎病 丙种球蛋白 阿司匹林 免疫功能 

分 类 号：R183.3[医药卫生—流行病学]