| 摘要: |
| 目的:探讨三联抗血小板方案辅助应用对川崎病患儿临床疗效、实验室指标及不良反应的影响。方法:选择我院2009-2016年收治的川崎病患儿共100例,以随机抽签法分为对照组和治疗组各50例,在丙种球蛋白静脉注射基础上分别加用常规抗血小板和三联抗血小板方案辅助治疗,比较两组患儿临床疗效及发热、淋巴结肿大、黏膜弥漫出血及肢体红斑缓解时间,治疗前后白细胞(WBC)、血小板(PLT)、降钙素原(PCT)、C 反应蛋白(CRP)、白细胞介素鄄6(IL-6)、肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)、巨噬细胞移动抑制因子(MIF)水平,冠状动脉损伤率及不良反应发生率。结果:治疗组总有效率96.00%,高于对照组的80.00%(P<0.05);治疗组患儿发热、淋巴结肿大、黏膜弥漫出血及肢体红斑缓解时间分别为（2.18±0.46）d、（3.43±0.79）d、（4.10±0.94）d、（3.43±0.85）d，均短于对照组的（3.42±0.60）d、（5.96±1.24）d、（5.63±1.35）d、（4.29±1.09）d（P<0.05）;两组患儿治疗后WBC低于治疗前,PLT高于治疗前(P<0.05);治疗组患儿治疗后以上指标改善情况均优于对照组(P<0.05);两组患儿治疗后PCT、CRP、IL-6、TNF-α、HMGB1及MIF水平均低于治疗前(P<0.05);治疗组患儿治疗后以上指标水平均低于对照组(P<0.05);治疗组患儿冠状动脉扩张和冠状动脉瘤发生率分别为10.00%、0.00%,低于对照组的28.00%、10.00% (P<0.05);两组患儿不良反应发生率比较差异无统计学意义(P<0.05)。结论:三联抗血小板方案辅助治疗川崎病患儿可有效缓解相关症状体征,改善血象指标,抑制机体炎症反应,拮抗血小板聚集,降低冠状动脉损伤风险,且未增加药物不良反应。 |
| 关键词: 抗血小板 川崎病 实验室指标 不良反应 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.11.004 |
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| 基金项目: |
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| Effects of Triple Antiplatelet Regimen on Clinical Efficacy and Laboratory Indicators in Children with Kawasaki Disease |
| Zhao Xiaohong |
| (Luohe Central Hospital of Henan, The First Affiliated Hospital of Luohe Medical College, Henan Luohe 462000, China) |
| Abstract: |
| Objective: To investigate the effects of triple antiplatelet regimen on clinical efficacy, laboratory indicators and adverse drug reactions of children with Kawasaki disease. Methods: Totally 100 children with Kawasaki disease admitted from Jan. 2009 to Dec. 2016 were extracted to be divided into control group and treatment group via the random lottery method, with 50 cases in each group. Routine antiplatelet and triple antiplatelet regimens were added on the basis of intravenous injection of gamma globulin for the patients. The clinical efficacy, remission time of fever, lymphadenopathy, mucosal diffuse hemorrhage and limb erythema, the white blood cell (WBC) count, platelet (PLT) count, procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high mobility group protein B1 (HMGB1) and macrophage migration inhibitory factor (MIF) levels before and after treatment, the incidence of coronary artery injury and the incidence of adverse drug reactions of two groups were compared. Results: The total effective rate of treatment group was 96.00%, higher than that of control group 80.00% (P<0.05). The remission time of fever, lymphadenopathy, mucosal diffuse hemorrhage and limb erythema of treatment group were respectively(2.18±0.46)d, (3.43±0.79)d, (4.10±0.94)d and (3.43±0.85)d, significantly shorter than those of control group (3.42±0.60)d, (5.96±1.24)d, (5.63±1.35)d and (4.29±1.09)d (P<0.05). After treatment, the WBC count of two groups was lower than that before treatment, and PLT count was higher than that before treatment (P<0.05). The improvement of the above indicators after treatment in treatment group was better than those in control group (P<0.05). The levels of PCT, CRP, IL-6, TNF-α, HMGB1 and MIF in two groups were lower than those before treatment (P<0.05). The above indicators of treatment group were lower than those of control group (P<0.05). The incidences of coronary artery dilatation and coronary artery aneurysm in treatment group were 10.00% and 0.00%, respectively, lower than those in control group (28.00% and 10.00%) (P<0.05). There was no significant difference in the incidence of adverse drug reactions between two groups (P<0.05). Conclusion: Triple antiplatelet regimen in assisted treatment of children with Kawasaki disease can efficiently relieve the related clinical symptoms and signs, improve the blood indicators, inhibit the inflammation reaction, antagonize the platelet aggregation and reduce the coronary artery injury risk without aggravating adverse drug reactions. |
| Key words: antiplatelet Kawasaki disease laboratory indicators adverse drug reactions |
