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目的:通过研究影响川崎病患儿血小板变化的相关因素,探讨川崎病患儿血小板水平升高的机制。方法:将36例川崎病患儿根据病程分为急性期组和恢复期组,同时纳入正常儿童23例作为对照组。测定三组儿童血小板(PLT)计数、平均血小板体积(MPV)、血小板分布宽度(PDW)、血清血小板生成素(TPO)水平、白细胞介素-1β(IL-1β)水平及血小板反应蛋白1(TSP-1)水平,比较三组患儿各指标的相关性。结果:川崎病患儿急性期组PLT计数升高,但与对照组比较差异无统计学意义(P>0.05);恢复期组PLT计数升高更明显,与急性期组和对照组比较差异有统计学意义(P<0.05)。急性期组MPV与对照组比较明显升高(P<0.05),恢复期组患儿MPV下降至正常水平,与对照组比较差异无统计学意义(P>0.05)。急性期组、恢复期组PDW均无显著变化(P>0.05)。急性期组患儿血清TPO、IL-1β和TSP-1水平明显高于恢复期组和对照组,组间比较差异有统计学意义(P<0.05);恢复期组TPO、IL-1β、TSP-1水平与急性期组比较均明显下降(P<0.05),TPO和TSP-1水平与对照组比较差异无统计学意义(P>0.05),而IL-1β水平仍高于对照组(P<0.05)。结论:川崎病患儿恢复期PLT计数升高可能与急性期血清细胞因子TPO、IL-1β及TSP-1水平有关。
Objective: To explore the mechanism of platelet increase in children with Kawasaki disease by studying the related factors affecting platelet changes in children with Kawasaki disease. Methods: Thirty-six children with Kawasaki disease were divided into acute phase group and convalescent phase group according to their course of disease. Twenty-three normal children were included as control group. The PLT count, mean platelet volume (MPV), platelet distribution width (PDW), serum TPO level, IL-1β level and thrombospondin 1 TSP-1) levels, the correlation between the three groups of children indicators. Results: The PLT count of children with acute Kawasaki disease increased in the acute stage, but there was no significant difference compared with the control group (P> 0.05). The PLT count increased more significantly in the recovery stage, compared with the acute stage group and the control group Statistical significance (P <0.05). MPV in acute phase group was significantly higher than that in control group (P <0.05). The MPV in convalescent group decreased to normal level compared with control group (P> 0.05). There was no significant change in PDW in acute phase and convalescent phase (P> 0.05). The levels of serum TPO, IL-1β and TSP-1 in children in acute phase group were significantly higher than those in recovery group and control group (P <0.05). The levels of TPO, IL-1β, TSP (P <0.05). The levels of TPO and TSP-1 were not significantly different from those of the control group (P> 0.05), but the level of IL-1β was still significantly higher than that of the control group <0.05). Conclusion: The elevated PLT count in convalescent children with Kawasaki disease may be related to the levels of serum cytokines TPO, IL-1β and TSP-1 in acute phase.