The Study On Treatment Of Kawasaki Disease With TanshiononeⅡA

Objective To study the treatment efficacy of the TanshinoneIIA in Kawasaki disease. The efficacy were evalued through the investigate the clinical and physical symptoms, echocardiographic, the detection of IL-6, IL-8, IL-1β, TNF-α, GMP-140, AnnexinV and blood routine, CRP , ESR in different treatment arms. And the mechanism of TanshinoneIIA in Kawasaki disease were studied as well.Methods Sixty-one KD patients diagnosed in Chengdu Children's Hospital from October 2009 to September 2010 were recruited in this study. The normal control group were consisted of 19 healthy children. The KD patients were randomly divided into two groups: study group (IVIG plus aspirin) , and TanshinoneIIA treatment group. In TanshinoneIIA treatment group, except for IVIG and aspirin , TanshinoneIIA was administrated intravenously for five to seven days. The blood samples were obtained before treatment and 5-7 daysafter treatment in the KD patients. IL-6, IL-8, IL-1β, TNF-αwere detected with enzymelinked immunosorbent assay(ELISA). GMP-140, AnnexinV were detected with wholeblood flowcytometry. Peripheral blood routine was measured using automatic hematocyte analyzer. Statistical analysis was done by software SPSS 17.0for Windows .Results1. The levels of serum IL-6, IL-8, IL-1β, TNF-αand plasma GMP-140, were significantly increased before the treatment for the KD patients compared to the controls (P<0.05). Plasma AnnexinV were increased before the treatment in the KD patients , but no statistical difference compared to the controls (P>0.05). 5 to 7 days after the treatment, the levels of serumIL-8 and TNF-αand were still significantly higher than that in the control group. The levels of serum IL-6, IL-1β, plasma GMP-140 and AnnexinV were no statistic difference from those in the control group (P>0.05).2. Before the treatment, there were no statistic differences of the levels of serum IL-6, IL-8, IL-1β, TNF-α, plasma GMP-140 and AnnexinV in the two treatment groups (P>0.05) . Five to seven days after the treatment, the levels of serum IL-6, IL-1βand plasma GMP-140 in TanIIA group decreased significantly compared with those in the regular treatment group. There were no statistical differences of the serum level of IL-8,TNF-αand plasma AnnexinV in the two treatment groups (P>0.05).3. There were no statistical differences of the PLT numbers before the treatment and after the treatment between the two treatment groups (P>0.05).4. After the treatment , the level of C-reaction protein decreased significantly and the duration of fever is shorter in TanIIA treatment group than those in the control group (P<0.05). There were no diferences of WBC, Hb, ESR and CKMB between the two treatment groups (P>0.05) . The coronary artery recoverd better in TanIIA treatment group than that in the control group, although the different was not statistic significant (P>0.05).Conclusion1. The serum level of IL-6, IL-1β, plasma GMP-140 were found increased in the treatment group with TanshinoneⅡA, which may decrease the vasculitis damage and PLT activation.2. The treatment with additional TanshinoneⅡA for the patients with KD resulted in a shorter fever duration, decreased CRP level, and an improving coronary arteylesion recovery.