匡云 杨帆 尹丹

摘要：目的  探讨川崎病（KD）不同时期血液流变学和免疫水平的临床意义。方法  选取2019年10月～2021年7月我院收治的KD患儿100例设为观察组，另选取同期健康体检儿童90例设为对照组。观察组于急性期（发病1～10d）、亚急性期（发病11～20d）和恢复期（发病21d～2个月）检测血液流变学和免疫功能指标，对照组于体检时进行检测。比较2组受检者血液流变学和免疫功能指标。结果  观察组急性期PLT、PCT、Fib、D-D明显高于恢复期及对照组（P<0.05），但明显低于亚急性期（P<0.05）;观察组亚急性期上述指標明显高于恢复期及对照组（P<0.05）;观察组恢复期上述指标高于对照组（P<0.05）。观察组急性期CD4+、CD4+/CD8+明显高于于亚急性期、恢复期及对照组（P<0.05），CD8+明显低于亚急性期、恢复期及对照组（P<0.05）;观察组亚急性期CD4+、CD4+/CD8+高于恢复期及对照组（P<0.05），CD8+低于恢复期及对照组（P<0.05）;观察组恢复期上述指标与对照组比较差异无统计学意义（P>0.05）。结论  KD患儿疾病不同时期血液流变学和免疫水平指标存在一定差异，对疾病的诊断、治疗具有指导意义。

关键词：川崎病;不同时期;血液流变学;免疫水平

Abstract： Objective To investigate the clinical significance of Hemorheology and immune level in different stages of Kawasaki disease （KD）. Methods 100 children with KD in our hospital from October 2019 to October 2020 were selected as the observation group， and 90 healthy children in the same period were selected as the control group. The indexes of Hemorheology and immune function in the observation group were detected in the acute stage （1-10 days of onset）， subacute stage （11-20 days of onset） and recovery stage （21 days-2 months of onset）， while those in the control group were detected in the physical examination. The indexes of Hemorheology and immune function were compared between the two groups. Results PLT， PCT， FIB， D-D of the observation group in acute stage were significantly higher than those in recovery stage and control group （P < 0.05）， but significantly lower than those in subacute stage （P < 0.05）; The above indexes in subacute stage of observation group were significantly higher than those in recovery stage and control group （P < 0.05）; The above indexes in the observation group were significantly higher than those in the control group （P < 0.05）. The CD4 + and CD4 + / CD8 + of the observation group in the acute stage were significantly higher than those in the subacute stage， the recovery stage and the control group （P < 0.05）， and the CD8 + was significantly lower than those in the subacute stage， the recovery stage and the control group （P < 0.05）; CD4 + and CD4 + / CD8 + in subacute stage of observation group were significantly higher than those in recovery stage and control group （P < 0.05）， and CD8 + was significantly lower than those in recovery stage and control group （P < 0.05）; There was no significant difference in the above indexes between the observation group and the control group （P > 0.05）. Conclusion there are some differences in hemorheology and immune level in different stages of KD， which has guiding significance for the diagnosis and treatment of KD.

Key words： Kawasaki disease; Different periods; Hemorheology; Immune level

【中图分类号】R725             【文献标识码】B             【文章编号】2107-2306（2021）0910--02

川崎病（KD）又称皮肤黏膜淋巴结综合征，是一种累及多器官和多系统的全身血管炎综合征。其主要表现为急性发热、皮肤黏膜损害和淋巴结肿大，严重者会出现冠状动脉损伤（CAL），导致儿童发生心血管病变的概率高居首位[1]。KD发病机制至今尚未明确，近年来研究发现免疫系统活化和血管内皮系统广泛损害与该病存在一定关联[2～3]。本研究通过观察KD患儿不同时期血液流变学和免疫水平的变化，探讨其临床意义，旨在为该病的临床诊治提供参考指标。……