CAJ | 학술논문

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.
목적 탐토대제량정맥면역구단백(IVIG)치료후,천기병(KD)병발관상동맥병변여관상동맥정상자혈백세포(WBC)、중성립세포、림파세포、혈소판(PLT)、C반응단백(CRP)급혈침(ESR)적변화정황.방법 수집접수IVIG치료,병차유치료전후혈액학검사결과적KD환자29례,근거초성심동도결과,장KD환자분위관상동맥정상(NCAL)조화관상동맥병변(CAL)조,기록량조환자재응용IVIG치료전여치료후1주내화2주내정맥혈WBC총수급기분류、PLT、CRP화ESR적결과,동시수집24례정상대조자WBC총수급기분류、PLT.결과 (1)치료전NCAL조화CAL조WBC총수급분류여대조조비교,차이균유통계학의의(P＜0.05);(2)IVIG치료후CAL조화NCAL조WBC총수、중성립세포명현강저,림파세포명현증고(P균<0.05);재CAL조,치료후1주내WBC총수잉고우대조조,이NCAL조WBC총수여대조조비교차이무통계학의의(P＞0.05).량조PLT변화불수IVIG영향이축점증고.(3)IVIG치료후CAL조CRP여치료전비교,차이유통계학의의(P＜0.01),NCAL조치료후CRP여치료전비교차이무통계학의의(P＞0.05).CAL조여NCAL조ESR재치료후여치료전비교,차이균무통계학의의(P＞0.05).결론 KD적발병여중성립세포화림파세포비례실형유관,IVIG가이통과회복WBC총수급중성립세포여림파세포적비례발휘치료작용.
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.