| 摘要: |
| 目的:探讨动态监测血小板功能指导阿司匹林剂量调整对川崎病(KD)恢复期患儿血清系统性免疫-炎症指数( SII)、 N 末端脑利钠肽前体(NT-proBNP)水平及预后的影响。 方法:选取沧州市中心医院 2021 年 5 月-2024 年 5 月收治的 260 例 KD 恢复期患儿随机分为常规组和精准调整组各 130 例。 常规组给予常规阿司匹林治疗,精准调整组采用血小板动态监测指导阿 司匹林剂量调整。 比较两组患儿疗效、症状消失时间、治疗前后免疫功能、炎症指标、血小板指标、心肌损伤指标和预后情况。 采用 logistic 回归分析筛选影响疗效的独立危险因素。 结果:精准调整组疗效优于常规组,症状消失时间短于常规组( P< 0. 05)。 治疗后,精准调整组 CD4+ 、CD4+ / CD8+ 、NK 细胞水平高于常规组,CD8+ 、SII、C 反应蛋白(CRP)、降钙素原(PCT)、白细 胞(WBC)、血小板反应蛋白-1(TSP-1)、血小板、NT-proBNP、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白 I(cTnI)、冠状动脉 Z 值低 于常规组(P<0. 05)。 两组患儿 1 年内不良事件发生率比较差异无统计学意义(P>0. 05)。 Logistic 回归分析显示,分组是患者 疗效的独立进影响因素(P<0. 05)。 结论:动态监测血小板功能指导阿司匹林剂量调整通过调节免疫功能、抑制炎症反应及血 小板活性,可提升 KD 恢复期患儿临床疗效,缩短症状消失时间,有效减轻心肌损伤。 |
| 关键词: 血小板功能动态监测 阿司匹林 剂量个体化调整 川崎病 恢复期 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2026.09.004 |
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| 基金项目:河北省卫生健康委员会资助项目,编号 20261289。 |
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| Individualized Aspirin Administration in Children with Kawasaki Disease During Recovery Period Guided by Dynamic Monitoring of Platelet Function |
| Bai Yajie, Shao Lili, Ma Ran, Zhang Feifei |
| (Cangzhou Central Hospital, Hebei Cangzhou 061000, China) |
| Abstract: |
| Objective: To probe into the effects of dynamic monitoring of platelet function and adjustment of aspirin dosage on the serum systemic immune-inflammatory index (SII), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, and prognosis in children with Kawasaki disease (KD) during recovery period. Methods: From May 2021 to May 2024, totally 260 children with KD during recovery period admitted into Cangzhou Central Hospital were randomly divided into the conventional group and precise adjustment group, with 130 cases in each group. The conventional group was treated with conventional aspirin treatment, while the precise adjustment group received the aspirin dosage adjustment guided by the dynamic monitoring of platelet function. The efficacy, disappearance time of symptoms, immune function, inflammatory factors, platelet markers, myocardial damage markers before and after treatment, and the prognosis of two groups were compared. Logistic regression analysis was used to screen the independent risk factors for efficacy. Results: The efficacy of precise adjustment group was better than that of conventional group, and the disappearance time of symptoms was shorter than that of conventional group ( P < 0. 05). After treatment, the CD4+ , CD4+ / CD8+ , NK cells in precise adjustment group were higher than those in conventional group, while the CD8+ , SII, C-reactive protein (CRP), procalcitonin (PCT), white blood cell (WBC), thrombospondin-1 (TSP-1), platelet, NT-proBNP, creatine kinase (CK-MB), cardiac troponin I (cTnI), coronary artery Z value were lower than those in conventional group (P<0. 05). There was no statistically significant difference in the incidence of adverse events within one year between two groups (P>0. 05). Logistic regression analysis showed that grouping was an independent protective risk factor for the curative effect of patients (P<0. 05). Conclusion: The aspirin dosage adjustment guided by dynamic monitoring of platelet function can improve the clinical efficacy of children with Kawasaki disease during recovery period, shorten the disappearance time of symptoms, and effectively reduce myocardial damage by regulating immune function, inhibiting inflammatory response, and modulating platelet activity. |
| Key words: dynamic monitoring of platelet function aspirin dosage individualization adjustment Kawasaki disease recovery period |
