2021 年第 2 期 第 16 卷

双嘧达莫联合静脉用丙种球蛋白对非典型川崎病患儿免疫功能和冠状动脉病变发生情况的影响

Effects of dipyridamole combined with intravenous immuneglobulin on immune function and coronary artery disease in children with atypical Kawasaki disease

作者：王德兵翟传华曹峰

英文作者：Wang Debing Zhai Chuanhua Cao Feng

单位：江苏省苏州市中西医结合医院儿科215000

英文单位：Department of Pediatrics Suzhou Integrated Traditional Chinese and Western Medicine Hospital Jiangsu Province Suzhou 215000 China

关键词：非典型川崎病；双嘧达莫；静脉用丙种球蛋白；免疫功能；冠状动脉病变

英文关键词：AtypicalKawasakidisease;Dipyridamole;Intravenousimmuneglobulin;Immunefunction;Coronaryarterydisease 

• 摘要：

• 目的 探讨双嘧达莫联合静脉用丙种球蛋白（IVIG）对非典型川崎病患儿免疫功能和冠状动脉病变发生情况的影响。方法 选取2018年4月至2020年4月苏州市中西医结合医院收治的非典型川崎病患儿94例，应用随机数字表法分为对照组和观察组，各47例。对照组给予阿司匹林联合静脉注射用丙种球蛋白治疗，观察组在对照组治疗基础上联合双嘧达莫治疗。比较2组冠状动脉损伤发生情况、临床症状消失时间、治疗前和治疗3个月后免疫功能指标水平、临床疗效和不良反应发生率。结果 治疗后2组 CD+3水平均高于治疗前，且观察组高于对照组［(66±8)%比（60±5）%］；CD+4和CD+8水平均低于治疗前，且观察组均低于对照组［(7.0±2.3)%比（11.5±3.1）%，(27±3)%比（30±6）%］（均P＜0.05）。观察组总有效率高于对照组［91.5%(43/47)比76.6%（36/47）］，发热、肢体肿胀、淋巴结肿大、黏膜充血和红斑消失时间均短于对照组（均P＜0.05）。2组冠状动脉损伤发生率和不良反应发生率比较差异均无统计学意义（均P＞0.05）。结论 双嘧达莫联合IVIG能改善非典型川崎病患儿免疫功能，缩短其临床症状消失时间，提高疗效，但对冠状动脉病变无明显影响。

• Objective To investigate the effects of dipyridamole combined with intravenous immuneglobulin (IVIG) on immune function and incidence of coronary artery disease in children with atypical Kawasaki disease. Methods Totally 94 children with atypical Kawasaki disease admitted to Suzhou Integrated Traditional Chinese and Western Medicine Hospital from April 2018 to April 2020 were selected. They were randomly divided into control group and observation group, with 47 cases in each group. The control group was treated with aspirin combined with IVIG, and the observation group was treated with dipyridamole on the basis of the control group. The incidence of coronary artery injury, time of disappearance of clinical symptoms, levels of immune function indicators before and 3 months after treatment, clinical curative  efficacy and incidence of adverse reactions were compared between the two groups. Results  After treatment, CD+3 levels in both groups were higher than those before treatment, and the level in observation group was higher than that in control group ［(66±8)% vs (60±5)%］; CD+4 and CD+8 levels in both groups were lower than those before treatment, and those in observation group were lower than those in control group ［(7.0±2.3)% vs (11.5±3.1)%, (27±3)% vs (30±6)%］(all P<0.05). The total effective rate of the observation group was higher than that of the control group ［91.5%(43/47) vs 76.6%(36/47)］, and the disappearance time of fever, limbs swelling, lymph nodes swelling, mucosal hyperemia and erythema of observation group were shorter than those of the control group (all P<0.05). There were no statistically significant differences between the two groups in the incidences of coronary artery injury and adverse reactions (both P>0.05). Conclusion Dipyridamole combined with IVIG can improve the immune function of children with atypical Kawasaki disease, shorten the disappearance time of clinical symptoms, and improve the therapeutic effect, while it has no significant effect on coronary artery disease.