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目的通过研究川崎病患儿血小板参数及血液流变学指标的变化,探讨血小板异常在冠状动脉病变发生、发展中的作用。方法选择年龄及性别相匹配的48例川崎病伴冠状动脉病变患儿及46例川崎病无冠状动脉病变患儿,另选49名健康儿为对照组,患儿于诊断明确后立即采血,健康儿与患儿同时采血,分别测血小板参数及血液流变学指标,每次采血后均在2 h内完成全部指标测定。结果冠状动脉病变组及无冠状动脉病变组血小板数目高于正常对照组(P<0.01),以冠状动脉病变组增高更为明显,冠状动脉病变组及无冠脉病变组血小板压积、平均血小板体积、血小板分布宽度均高于正常对照组(P<0.05或<0.01),以冠状动脉病变组增加更为明显。冠状动脉病变组及无冠状动脉病变组全血黏度高切、低切,血浆黏度,红细胞压积,红细胞聚集指数,血沉,血沉方程K值均高于正常对照组(P<0.05或P<0.01),以冠状动脉病变组更为明显。结论血小板功能亢进和高血黏滞状态在川崎病冠状动脉病变的发生、发展中起很重要的作用。血液黏稠度可能与川崎病冠状动脉病变的严重程度有关,如能早期改善血小板功能及血液流变学紊乱,可预防川崎病冠状动脉损害与发展。
Objective To study the changes of platelet parameters and hemorheology indexes in children with Kawasaki disease and to explore the role of platelet abnormalities in the occurrence and development of coronary lesions. Methods Forty-eight children with Kawasaki disease with coronary artery disease and 46 children with Kawasaki disease without coronary artery disease were enrolled in the study. 49 healthy children were selected as control group. Blood samples were collected immediately after diagnosis Children and children at the same time blood collection, respectively, platelet parameters and hemorheology indicators, after each blood collection within 2 h to complete the determination of all indicators. Results The number of platelets in coronary artery disease group and non-coronary artery disease group was higher than that in the normal control group (P <0.01), and coronary artery lesion group increased more obviously. In the coronary artery lesion group and the coronary artery lesion group, the platelet pressure, mean platelet count Volume and platelet distribution width were higher than the normal control group (P <0.05 or <0.01), coronary artery lesions increased more significantly. The values of high shear viscosity, hematocrit, hematocrit, erythrocyte aggregation index, erythrocyte sedimentation rate, erythrocyte sedimentation rate, erythrocyte sedimentation rate and erythrocyte sedimentation rate in coronary artery disease group and non-coronary artery disease group were all higher than those in normal control group (P <0.05 or P <0.01 ), To coronary artery disease group more obvious. Conclusion Platelet hyperactivity and high blood viscosity status plays an important role in the occurrence and development of coronary artery lesions in Kawasaki disease. Blood viscosity may be related to the severity of Kawasaki disease coronary artery disease, such as early improvement of platelet function and blood rheology disorders, can prevent Kawasaki disease coronary artery damage and development.