摘要
目的探讨大剂量静脉免疫球蛋白(IVIG)治疗后,川崎病(KD)并发冠状动脉病变与冠状动脉正常者血白细胞(WBC)、中性粒细胞、淋巴细胞、血小板(PLT)、C反应蛋白(CRP)及血沉(ESR)的变化情况。方法收集接受IVIG治疗,并且有治疗前后血液学检查结果的KD患者29例,根据超声心动图结果,将KD患者分为冠状动脉正常(NCAL)组和冠状动脉病变(CAL)组,记录两组患者在应用IVIG治疗前与治疗后1周内和2周内静脉血WBC总数及其分类、PLT、CRP和ESR的结果,同时收集24例正常对照者WBC总数及其分类、PLT。结果(1)治疗前NCAL组和CAL组WBC总数及分类与对照组比较,差异均有统计学意义(P<0.05);(2)IVIG治疗后CAL组和NCAL组WBC总数、中性粒细胞明显降低,淋巴细胞明显增高(P均<0.05);在CAL组,治疗后1周内WBC总数仍高于对照组,而NCAL组WBC总数与对照组比较差异无统计学意义(P>0.05)。两组PLT变化不受IVIG影响而逐渐增高。(3)IVIG治疗后CAL组CRP与治疗前比较,差异有统计学意义(P<0.01),NCAL组治疗后CRP与治疗前比较差异无统计学意义(P>0.05)。CAL组与NCAL组ESR在治疗后与治疗前比较,差异均无统计学意义(P>0.05)。结论KD的发病与中性粒细胞和淋巴细胞比例失衡有关,IVIG可以通过恢复WBC总数及中性粒细胞与淋巴细胞的比例发挥治疗作用。
Objective To study the effect of intravenous immunoglobulin （IVIG） on Kawasaki disease（KD） -related blood indicators. Methods The number of white blood cells （ WBC ） , neutrophil （ N ） , lymphocytes （L） , platelet count （PLT） , C -reactive protein （CRP） ,and erythrocyte sedimentation rate （ESR） in 29 KD children were record before and after IVIG treatment （ including within 1 week, 1 and 2 weeks after IVIG）. Patients were divided into ,coronary artery lesions （CAL） group （ n = 13 ） and non - coronary artery lesion （NCAL） group （ n = 16）. The clinical data of another 24 normal children were also collected as normal control. Results 1. WBC and N were significantly higher in CAL and NCAL group than in controls （ P 〈 0. 05 ） , while L was significantly lower than in controls （ P 〈 O. 05 ）. After IVIG treatment, WBC and N significantly decreased （ P 〈 0. 05） and L significantly increased （P 〈 0. 05）. However,in CAL group, WBC remained significantly higher than controls within 1 week after IVIG treatment （P 〈 0. 05）. PLT continuously increased in both CAL and NCAL groups. CRP significantly decreased after IVIG treatment, in CAL group（P 〈0.01 ）, while such change was not significant in NCAL group （P 〉0. 05）. ESR was not changed after IVIG treatment in both two groups（ P 〉 0. 05 ）. Conclusion The imbalance of neutrophil and lymphocytes may play a role in the pathogenesis of KD. IVIG may provide some therapeutic effect on KD by returning N and L to normal levels.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第6期601-603,共3页
Chinese General Practice
关键词
黏膜皮肤淋巴结综合征
静脉免疫球蛋白
白细胞
血小板
C-反应蛋白
血沉
Muco - cuta - neouslymph node syndrome
Intravenous immunoglobulin
White blood cells
Platelet
C - reactive protein
Erythrocyte sedimentation rate
