【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。更多还原

【Abstract】 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<0.05).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.更多还原