2019 年第 4 期 第 14 卷

大剂量丙种球蛋白联合阿司匹林治疗川崎病患儿的临床效果

Clinical efficacy of high dose gamma globulin combined with aspirin in treatment of Kawasaki disease

作者：张慧玲

英文作者：

单位：110000沈阳，解放军第二〇二医院儿科

英文单位：

关键词：川崎病；丙种球蛋白；阿司匹林；炎性因子；T淋巴细胞亚群；血管内皮生长因子

英文关键词：

• 摘要：

• 【摘要】目的    观察大剂量丙种球蛋白联合阿司匹林治疗川崎病的临床效果。方法    选取2015年2月至2018年1月解放军第二〇二医院儿科收治的川崎病患儿78例，完全随机分为观察组与对照组，每组39例。观察组给予阿司匹林口服和大剂量丙种球蛋白静脉滴注，对照组除同法使用阿司匹林外，另给予常规剂量丙种球蛋白，2组患儿均治疗2～3个月。比较2组治疗前后炎性因子、T淋巴细胞亚群以及血清血管内皮相关指标水平。结果    治疗前，2组患儿的高敏C反应蛋白（hs-CRP）、肿瘤坏死因子α（TNF-α）、血清降钙素原、白细胞介素10（IL-10）、CD+4、CD+8、CD+4/CD+8、内皮抑素、血管内皮生长因子（VEGF）差异均无统计学意义（均P＞0.05）。治疗后，观察组hs-CRP、TNF-α、血清降钙素原、IL-10低于对照组［（1.56±0.24）ng/L比（8.36±0.25）ng/L、（13.2±1.9）ng/L比（17.3±2.0）ng/L、（0.81±0.11）ng/L比（6.67±1.38）ng/L、（0.06±0.01）ng/L比（0.13±0.02）ng/L］，CD+4、CD+4/CD+8低于对照组, CD+8高于对照组［（37.6±1.9）%比（40.7±2.0）%、（1.03±0.17）比（1.20±0.17）、（40.26±0.13）%比（38.05±0.12）%］，内皮抑素、VEGF低于对照组［（11.42±0.25）ng/L比（20.57±0.32）ng/L、（31±4）pg/L比（54±6）pg/L］，差异均有统计学意义（均P＜0.05）。结论    对川崎病患儿使用大剂量丙种球蛋白联合阿司匹林治疗，能有效降低炎性因子水平，改善T淋巴细胞亚群和血管内皮因子水平，效果满意。

• 【Abstract】Objective    To observe the clinical efficacy of high dose gamma globulin combined with aspirin in the treatment of Kawasaki disease. Methods    Seventy-eight children with Kawasaki disease admitted to the 202nd Hospital of Chinese People′s Liberation Army from February 2015 to January 2018 were enrolled. They were randomly divided into observation group and control group, with 39 cases in each group. The observation group was given oral aspirin and intravenous infusion of high dose of gamma globulin. The control group was given oral aspirin and routine dose of gamma globulin. Both groups were treated for 2-3 months. Inflammatory factors, T lymphocyte subsets and vascular endothelial related indexes were analyzed. Results    Before treatment, there was no significant difference of high-sensitivity C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), procalcitonin(PCT), interleukin-10(IL-10), CD+4, CD+8, CD+4/CD+8, endostatin and vascular endothelial growth factor(VEGF) between groups(P>0.05). After treatment, serum levels of hs-CRP, TNF-α, PCT and IL-10 in the observation group were lower than those in the control group［（1.56±0.24）ng/L vs （8.36±0.25）ng/L, （13.2±1.9）ng/L vs （17.3±2.0）ng/L, （0.81±0.11）ng/L vs （6.67±1.38）ng/L, （0.06±0.01）ng/L vs （0.13±0.02）ng/L］; CD+4 and CD+4/CD+8 in the observation group were lower and CD+8 was higher than those in the control group［（37.6±1.9）% vs （40.7±2.0）%, （1.03±0.17） vs （1.20±0.17）,（40.26±0.13）% vs （38.05±0.12）%］; levels of endostatin and VEGF in the observation group were lower than those in the control group［（11.42±0.25）ng/L vs （20.57±0.32）ng/L,（31±4）pg/L vs （54±6）pg/L］(all P<0.05). Conclusion    High dose gamma globulin combined with aspirin treating children with Kawasaki disease can effectively improve T lymphocyte subsets balance, reduce inflammatory factors and vascular endothelial factors.