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目的观察静脉注射免疫球蛋白（IVIG）对川崎病（KD）患儿外用血淋巴细胞凋亡的影响，进一步探讨IVIG的治疗机制。方法观察26例KD患儿IVIG治疗前后外周血单个核细胞（PBMC）经anti-CD3单抗刺激培养不同时间后计数凋亡细胞百分率和DNA梯度分析及临床症状改善。结果KD患儿PBMC体外培养凋亡细胞百分率较正常对照低，DNA梯度出现延迟；IVIG治疗后，PBMC凋亡细胞百分率提高（P＜0．001），DNA梯度出现时间提前，与单用阿司匹林组比较，有显著差异（P＜0．005），临床症状明显改善。结论IVIG治疗KD的机制可能部分归于逆转被抑制的淋巴细胞凋亡。
Objective To observe the effect of intravenous immunoglobulin (IVIG) on the apoptosis of peripheral blood lymphocytes in children with Kawasaki disease (KD), and to further explore the therapeutic mechanism of IVIG. Methods Peripheral blood mononuclear cells (PBMCs) of 26 children with KD treated with anti-CD3 mAb were cultured for different time before and after IVIG treatment. The percentages of apoptotic cells and DNA gradient analysis and clinical symptom improvement were observed. Results The percentages of apoptotic cells in PBMCs cultured with KD were lower than those in normal controls and the DNA gradient was delayed. The percentages of apoptotic cells in PBMCs were increased after IVIG treatment (P <0.001), and the DNA gradient appeared earlier than that of aspirin alone Compared with significant differences (P <0.005), clinical symptoms improved significantly. Conclusions The mechanism of IVIG treatment of KD may be attributed in part to the reversal of suppressed apoptosis of lymphocytes.