| 岳上赛,孙凤平.基于“玄府 -气液”理论探究防风通圣散对静脉注射免疫球蛋白抵抗型黏膜皮肤淋巴结综合征病儿系统性免疫炎症指数、 C反应蛋白与白蛋白比值的影响[J].安徽医药,2026,30(7):1441-1447. |
| 基于“玄府 -气液”理论探究防风通圣散对静脉注射免疫球蛋白抵抗型黏膜皮肤淋巴结综合征病儿系统性免疫炎症指数、 C反应蛋白与白蛋白比值的影响 |
| Effects of Fangfeng Tongsheng San on systemic immune inflammation index and C-reactive protein to albumin ratio in children with intravenous immunoglobulin resistant mucocutaneous lymph node syndrome complicated with coronary artery lesions: a study based on the "Xuanfu-Qiye" theory |
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| DOI：10.3969/j.issn.1009-6469.2026.07.033 |
| 中文关键词: 黏膜皮肤淋巴结综合征 IVIG抵抗 冠脉损害 系统性免疫炎症指数 C反应蛋白与白蛋白比值 防风通圣散 |
| 英文关键词: Mucocutaneous lymph node syndrome Intravenous immunoglobulin resistant Coronary artery lesions Systemic im-mune inflammation index C-reactive protein to albumin ratio Fangfeng Tongsheng San |
| 基金项目:河南省中医药传承与创新人才工程(仲景工程)中医药学科拔尖人才项目( 3204221110401) |
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| 中文摘要: |
| 目的探讨系统性免疫炎症指数( systemic immune inflammation index，SII)及 C反应蛋白与白蛋白比值( C-reactive pro-tein to albumin ratio，CAR)作为生物标志物在评估静脉注射免疫球蛋白( intravenous immunoglobulin，IVIG)抵抗型黏膜皮肤淋巴结综合征( mucocutaneous lymph node syndrome，MCLS)病儿合并冠脉病变( coronary artery lesion，CAL)中的意义；基于“玄府 -气液”理论从微观角度探讨 MCLS的发病机制，评价防风通圣散预防 IVIG抵抗型 MCLS合并 CAL的临床疗效。方法前瞻性收集河南省儿童医院自 2017年 12月至 2022年 7月收治的 IVIG抵抗型 MCLS病儿共 58例，检测所有病儿急性期血清白细胞计数、中性粒细胞计数、血小板计数、 C反应蛋白、白蛋白水平及彩超监测下冠脉 Z值情况，应用受试者操作特征曲线(receiver op-erating characteristic curve，ROC曲线)分析急性期 SII和 CAR对 IVIG抵抗型 MCLS病儿合并 CAL的诊断效能；按区组随机分组法分为观察组和对照组各 29例，对照组给予静注人免疫球蛋白、激素联合阿司匹林治疗，观察组在对照组治疗基础上给予防风通圣散治疗，中药治疗周期 1个月。观察两组治疗前后 SII和 CAR及彩超监测下冠脉 Z值情况，随访周期 1年。结果与非冠脉损伤组比较， MCLS急性期冠状动脉损伤组血清 SII(1 083.71±724.25比 2 310.19±1 047.75)及 CAR(1.36±1.23比 3.07±1.52)水平明显升高，差异有统计学意义( P<0.001)； SII及 CAR诊断 IVIG抵抗型 MCLS病儿合并 CAL的 ROC曲线下面积分别为 0.84和 0.95；治疗后，与对照组比较，观察组病儿血清 SII(537.01±195.63比 255.80±217.78)及 CAR(0.15±0.05比 0.06±0.04)水平明显降低，随访 1年合并 CAL发生率更低［ 3.44%(1/29)比 27.58%(8/29)］。结论 SII升高、 CAR升高是 IVIG抵抗型 MCLS病儿发生冠脉损伤的危险因素。 SII及 CAR对诊断 IVIG抵抗型 MCLS病儿合并 CAL的诊断效能高，或可替代冠脉彩超成为预测 MCLS合并 CAL的更加简便高效的生物标志物。加用防风通圣散治疗可降低 IVIG抵抗型 MCLS病儿合并 CAL的风险。 |
| 英文摘要: |
| Objective To explore the significance of systemic immune inflammation index (SII) and C-reactive protein to albumin ra-tio (CAR) as biomarkers for in the evaluation of children with intravenous immunoglobulin (IVIG)-resistant mucocutaneous lymph nodesyndrome(MCLS) complicated with coronary artery lesions(CAL) and to observe the clinical efficacy of Fangfeng Tongsheng San in pre-venting IVIG-resistant MCLS combined with CAL by exploring the pathogenesis of MCLS from the microscopic perspective based on the "Xuanfu-Qiye" theory.Methods Prospective collection 58 cases with IVIG-resistant MCLS treated in He'nan Children's Hospitalfrom December 2017 to July 2022. Blood indexes including leukocyte count, neutrophil count, platelet count, C-reactive protein and al-bumin levels were detected at acute stage. Meanwhile, coronary Z value was monitored by color ultrasound. The receiver operating char-acteristic curve (ROC curve) was applied to assess the diagnostic efficacy of SII and CAR in IVIG-resistant MCLS with CAL. All cases were randomly assigned into an observation group (n=29) or a control group (n=29). The control group was treated with IVIG, glucocorti-coid and aspirin, while the observation group was treated with Fangfeng Tongsheng San for 1 month in addition to the treatment admin-istered to the control group. The levels of SII, CAR and coronary Z value before and after treatment were observed in both groups, with a follow-up period of 1 year.Results Compared with the non-coronary lesions group, the levels of SII (1 083.71±724.25 vs. 2 310.19±1 047.75) and CAR (1.36±1.23 vs. 3.07±1.52) were higher in coronary lesions group with statistically significant difference (P<0.001). The areas under ROC curve of of SII and CAR for diagnosing CAL in children with IVIG-resistant MCLS were 0.84 and 0.95, respec-tively. After treatment, compared with the control group, the levels of serum SII (537.01±195.63 vs. 255.80±217.78) and CAR (0.15±0.05 vs. 0.06±0.04) in the observation group were significantly reduced, and the incidence of CAL [3.44%(1/29) vs. 27.58%(8/29)] be-came even lower during the one-year follow-up.Conclusions Elevated SII and CAR were risk factors for CAL in children with IVIG-resistant MCLS. SII and CAR demonstrate high diagnostic efficacy for detecting CAL in children with IVIG-resistant MCLS, which mayserve as simpler and more efficient biomarkers to replace coronary echocardiography. Additionally, the risk of CAL in children withIVIG-resistant MCLS could be reduced by treating with Fangfeng Tongsheng San. |
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