| 摘要: |
| [摘要]目的：探讨血小板在川崎病（KD）患儿急性期及恢复期变化的临床意义。方法：回顾性收集我院2016年的KD住院患儿临床资料，探讨急性期血小板变化与静脉丙种球蛋白（IVIG）治疗无反应KD及冠状动脉病变（CAL）之间的关系，以及在恢复期对小剂量阿司匹林应用的指导意义。结果：本研究共纳入808例KD患儿。IVIG治疗无反应组36例（4.46%），IVIG治疗有反应组772例（95.54%）。IVIG治疗无反应组患儿的血小板计数（PLT）、血小板压积（PCT）低于IVIG治疗有反应组，血小板平均体积（MPV）高于IVIG治疗有反应组（P均<0.05）。恢复期有CAL（CAL组）178例（22.03%），恢复期无CAL（nCAL组）630例（77.97%）。规律随访并服用小剂量阿司匹林的恢复期nCAL患儿420例，服药6周后321例（76.43%）PLT可降至400×109/L以下，服药8周为355例（84.52%），差异有统计学意义（c2=8.76，P<0.05）；12周为371例（88.33%），与8周时比较差异无统计学意义（c2=2.60，P>0.05）。结论：PLT、PCT、MPV急性期变化可能与IVIG治疗无反应相关，与CAL无明显关系。对无CAL或一过性冠脉扩张的绝大多数KD患儿，口服小剂量阿司匹林疗程在6~8周适宜。 |
| 关键词: 川崎病 血小板 急性期 恢复期 儿童 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2020.05.006 |
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| 基金项目: |
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| Significance of Changes of Platelet in Children with Kawasaki Disease during Different Period in Clinical Therapy Strategies |
| Chen Xiaodong, Zhang Jing |
| (Children’s Hospital of Chongqing Medical University, National Demonstration Base of Standardized Training Base for Resident Physicians, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China) |
| Abstract: |
| [Abstract] Objective: To probe into the clinical significance of changes of platelet (PLT) in children with Kawasaki disease (KD) during acute and recovery period. Methods: Clinical data of hospitalized children with KD in our hospital in 2016 were retrospectively collected to investigate the relationship between changes of platelet during acute period and non-responsive intravenous gamma globulin (IVIG) treatment of KD and coronary artery disease (CAL), the guiding significance on the application of low-dose aspirin during recovery period was analyzed. Results: A total of 808 children with KD were collected. There were 36 cases (4.46%) in non-responsive IVIG group and 772 cases (95.54%) in responsive IVIG group. The PLT count and platelet hematocrit (PCT) of children in non-responsive IVIG group were lower than those in responsive IVIG group, and the mean platelet volume (MPV) was higher than that in responsive IVIG group (P<0.05). There were 178 cases (22.03%) with CAL (CAL group) and 630 cases (77.97%) without CAL (nCAL group) during recovery period. Totally 420 cases in nCAL group took low-dose aspirin regularly were followed up. PLT count in 321 cases (76.43%) was lower than 400×109/L after 6 weeks, 355 cases (84.52%) was lower than 400×109/L after 8 weeks, the difference was statistically significant (c2=8.76, P<0.05). PLT count in 371 cases (88.33%) was lower than 400×109/L after 12 weeks, compared with 8 weeks, the difference was not statistically significant (c2=2.60, P>0.05). Conclusion: Changes of PLT, PCT, and MPV during acute period may be related to non-responsive IVIG treatment, and have no significant relationship with CAL. For the majority of children with KD and without CAL or transient coronary dilatation, 6 to 8 weeks of oral low-dose aspirin treatment is appropriate. |
| Key words: Kawasaki disease platelet acute period recovery period children |
