Effect of high-dose gamma globulin combined aspirin on vascular endothelial factor, resistin and visfatin of children with Kawasaki disease
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摘要: 目的 探讨大剂量丙种球蛋白联合阿司匹林对川崎病患儿血管内皮因子及抵抗素和内脂素的影响并观察其临床疗效。 方法 选择杭州市第一人民医院2015年1月-2016年12月收治的62例川崎病患儿为观察组,给予大剂量丙种球蛋白与阿司匹林治疗,其中大剂量丙种球蛋白为2 g/(kg·d),静脉注射,阿司匹林肠溶片30~50 mg/(kg·d),分3次口服,退热3 d后减为3~5 mg/(kg·d),一次口服,连续治疗2个月。另选取同期在我院进行体检的62例健康儿童作为对照组。治疗前后,采用酶联免疫吸附法测定炎症因子(hs-CRP、TNF-α)与血管内皮相关指标(VEGF、eNOS、ES)水平、双抗体夹心法测定炎症因子PCT水平及双抗体酶联免疫吸附法测定抵抗素、内脂素水平的变化,并与对照组比较,统计治疗效果。 结果 治疗后,观察组PCT、hs-CRP、TNF-α水平均明显降低(P<0.05)。治疗后,观察组VEGF、ES、抵抗素、内脂素水平显著降低(均P<0.05);eNOS水平明显升高(P<0.05)。治疗总有效率为91.93%。 结论 大剂量丙种球蛋白联合阿司匹林可明显降低川崎病患儿机体炎症反应,减轻血管内皮损伤,其作用机制可能与大剂量丙种球蛋白联合阿司匹林能有效调节患儿的抵抗素和内脂素有关。Abstract: Objective To investigate the effect of high-dose gamma globulin combined aspirin on vascular endothelial factor,resistin and visfatin of children with Kawasaki disease and observe its clinical efficacy. Methods A total of 62 patients with Kawasaki disease in Hangzhou First People's Hospital from January, 2015 to December, 2016 were selected as the observation group and treated with large doses of gamma globulin and aspirin.High-dose gamma globulin was 2 g/(kg·d),intravenous injection,and aspirin enteric-coated tablets. 30-50 mg/(kg·d) was given orally 3 times,reduced to 3-5 mg/(kg·d) 3 days after antipyretic therapy,and administered orally once a day for 2 months. Another 62 healthy children who had physical examination in our hospital during the same period were selected as the control group.Before and after treatment,the levels of inflammatory factors (hs-CRP, TNF-α) and vascular endothelium-related markers (VEGF, eNOS, ES) were measured by enzyme-linked immunosorbent assay, PCT levels were measured by double-antibody sandwich assay, resistin and visfatin levels were measured by double-antibody enzyme-linked immunosorbent assay. The therapeutic effect was compared with the control group. Results After treatment,the PCT, hs-CRP and TNF-α levels of observation group were significantly reduced (P<0.05). After treatment, VEGF, ES, resistin and visfatin levels of observation group were significantly decreased (P<0.05), and the eNOS level was significantly increased (P<0.05). The total effective rate of treatment was 91.93%. Conclusion High-dose gamma globulin combined with aspirin can significantly reduce the inflammatory response of children with Kawasaki disease and reduce vascular endothelial injury. The mechanism may be related to the large dose of gamma globulin combined with aspirin can effectively regulate the resistin and visfatin in children.
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Key words:
- Kawasaki disease /
- Gamma globulin /
- Aspirin /
- Vascular endothelial factor /
- Resistin /
- Visfatin
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