摘要
目的:分析英夫利息单抗联合静脉注射人免疫球蛋白治疗难治性川崎病的效果及对血小板计数、C反应蛋白水平的影响。方法:选取2022年1月至2025年1月80例难治性川崎病患儿作为研究对象,应用随机数字表法进行分组,40例对照组采取静脉注射人免疫球蛋白治疗,40例试验组采取英夫利息单抗联合静脉注射人免疫球蛋白治疗。比较两组临床疗效,治疗前后炎症指标,血液相关指标,心血管相关指标水平,并比较两组不良反应情况。结果:试验组总有效率95.00%高于对照组80.00%(P<0.05);炎症相关生物标志物的动态监测显示,治疗后,两组基质金属蛋白酶-9(MMP-9)、C反应蛋白(CRP)、单核细胞趋化蛋白-1(MCP-1)、肿瘤坏死因子-α(TNF-α)均降低,试验组低于对照组(P<0.05);血液学参数分析表明,治疗后,两组血小板、D-二聚体、纤维蛋白原均降低,试验组低于对照组(P<0.05);心血管系统评估结果显示,治疗后,两组冠脉Z值、肌酸激酶同工酶(CK-MB)、肌钙蛋白I均降低,试验组CK-MB、肌钙蛋白I低于对照组,两组左心室射血分数(LVEF)均升高,试验组高于对照组(P<0.05);两组胃肠道反应、皮疹、肝功能异常、上呼吸道感染相关不良反应发生率比较均无明显差异(P>0.05)。结论:英夫利息单抗联合静脉注射人免疫球蛋白治疗难治性川崎病效果显著,可降低患儿炎症反应水平,改善血小板、D-二聚体、纤维蛋白原等血液相关指标,改善心功能,且安全性较高。
Objective:To analyze the efficacy of Infliximab combined with immunoglobulin in the treatment of refractory Kawasaki disease and its effects on platelet count and C-reactive protein levels.Method:80 children with refractory Kawasaki disease from January 2022 to January 2025 were selected as the study subjects.Random number table method was used for grouping,with 40 cases in the matched group treated with immunoglobulin and 40 cases in the experimental group treated with Infliximab combined with immunoglobulin.Compare the clinical efficacy,inflammation indicators,blood related indicators,cardiovascular related indicators levels before and after treatment between two groups,and compare the adverse reactions between the two groups.Result:The total effective rate of the experimental group was 95.00%,which was higher than the matched group's 80.00%(p<0.05);The dynamic monitoring of inflammation related biomarkers showed that After treatment,the levels of matrix metalloproteinase-9(MMP-9),C-reactive protein(CRP),monocyte chemoattractant protein-1(MCP-1),and tumor necrosis factor alpha(TNF-α)decreased in both groups,with the experimental group lower than the matched group(P<0.05);The analysis of hematological parameters showed that after treatment,the levels of platelets,D-dimer,and fibrinogen in both groups decreased,and the experimental group was lower than the matched group(p<0.05);The cardiovascular system assessment results showed that after treatment,the coronary Z-value,creatine kinase(CK-MB),and troponin I in both groups decreased,while CK-MB and troponin I in the experimental group were lower than those in the matched group.The left ventricular ejection fraction(LVEF)in both groups increased,with the experimental group being higher than the matched group(p<0.05);There was no difference in the incidence of gastrointestinal reactions,rash,liver dysfunction,and upper respiratory tract infection related adverse reactions between the two groups(P>0.05).Conclusion:The combination of Infliximab and immunoglobulin has a significant effect on the treatment of refractory Kawasaki disease.It can reduce the inflammatory response level in children,improve blood related indicators such as platelets,D-dimer,and fibrinogen,improve cardiac function,and has high safety.
作者
林淑斌
张砚茹
杨雅婷
林锋
方琼
LIN Shu-bin;ZHANG Yan-ru;YANG Ya-ting;LIN Feng;FANG Qiongl(Shengli Clinical Medical College of Fujian Medical University,Fuzhou,Fujian,350001,China;Department of Cardiovascular Medicine,Childrens Hospital of Fudan University at Xiamen(Xiamen Childrens Hospital),Xiamen,Fujian,361006,China;Department of Pediatric Intensive Care Medicine,Childrens Hospital of Fudan University at Xiamen(Xiamen Childrens Hospital),Xiamen,Fujian,361006,China;Department of Ultrasound Medicine,Childrens Hospital of Fudan University at Xiamen(Xiamen Childrens Hospital),Xiamen,Fujian,361006,China)
出处
《现代生物医学进展》
2025年第22期3538-3545,共8页
Progress in Modern Biomedicine
基金
2024年福建省卫生健康中青年骨干人才培养项目(2024GGB26)。
