Glode M P, Joffe L S, Wiggins J, Clarke S H, Hathaway W E
Kempe Research Center, Denver.
J Pediatr. 1989 Sep;115(3):469-73. doi: 10.1016/s0022-3476(89)80859-5.
We studied the effects of immune globulin and aspirin versus aspirin alone on platelet count, platelet activation, and factor-mediated coagulation in patients with Kawasaki syndrome. Coagulation tests were performed on the day of admission to the study and 4 to 6 days later. Twenty-three patients were enrolled; 12 received immune globulin intravenously plus aspirin, and 11 received aspirin alone. At initiation of the study the groups were comparable with regard to age, sex, race, and time from onset of illness to study entry. Coagulation values were similar at entry with the exception that the aspirin group had a geometric mean platelet count that was higher than the platelet count in the aspirin-immune globulin group (p = 0.02). Four days after entry there were no significant differences between the two groups in any coagulation studies. Although the immune globulin preparation used has been effective in reducing the prevalence of coronary artery aneurysms, it appears to have no early effect on reduction of platelet activation or other measures of coagulopathy. The mechanism of action of immune globulin in patients with Kawasaki syndrome remains to be elucidated.
我们研究了免疫球蛋白和阿司匹林联合用药与单独使用阿司匹林相比，对川崎综合征患者血小板计数、血小板活化及因子介导的凝血功能的影响。在研究入组当天及4至6天后进行凝血检测。共纳入23例患者，其中12例静脉注射免疫球蛋白加阿司匹林，11例仅接受阿司匹林治疗。研究开始时，两组在年龄、性别、种族以及从发病到入组研究的时间方面具有可比性。入组时凝血指标相似，但阿司匹林组的血小板几何平均计数高于阿司匹林-免疫球蛋白组（p = 0.02）。入组4天后，两组在任何凝血研究中均无显著差异。尽管所用的免疫球蛋白制剂已有效降低了冠状动脉瘤的发生率，但它似乎对降低血小板活化或其他凝血异常指标无早期作用。免疫球蛋白在川崎综合征患者中的作用机制仍有待阐明。
