不同剂量丙种球蛋白对川崎病患儿的疗效及对冠状动脉病变的影响

摘要

目的 评价静脉注射不同剂量的丙种球蛋白(intravenous immune globulin,IVIG)治疗川崎病(Kawasaki disease,KD)的临床效果及对冠状动脉病变的影响.方法 选取我院儿科2006年4月～2011年10月收治的102例KD患儿,随机分为观察组和对照组,每组各51例.观察组患儿给予IVIG 1 g/kg静脉注射,对照组患儿给予IVIG 2 g/kg静脉注射,对两种治疗方法的疗效进行比较.观察患儿总热程、退热时间、黏膜充血、手足肿胀和颈淋巴结肿大消退时间,监测外周血白细胞计数(white blood cells count,WBC)、血小板计数(platelet count,PLT)、C反应蛋白(creacting prorein,CRP)、血沉(erythrocyte sedimentation rate,ESR)和冠状动脉病变(coronary artery lesion,CAL)发生情况.结果 两组住院时间、退热时间、黏膜充血、手足肿胀和颈淋巴结肿大消退时间及总热程比较,差异无统计学意义(P＞0.05)；两组WBC、PLT、CRP、ESR与治疗前比较明显降低(P＜0.05),两组间比较,差异无统计学意义(P＞ 0.05).观察组CAL发生率为25.5％,对照组CAL发生率为21.6％,两组比较,差异亦无统计学意义(P＞0.05).结论 IVIG 1 g/kg单次静脉注射治疗KD,可有效缓解临床症状,降低CAL的发生率,且与IVIG 2g/kg单次静脉注射治疗KD比较治疗效果相似.%Objective To evaluate the clinical effect on different dosage of intravenous immune globulin (IVIG) in the treatment of Kawasaki disease and its influence on coronary artery lesion. Methods 102 cases of patients with Kawasaki disease in our hospital from April 2010 to October 2011 were randomly divided into the observation group and the control group, and each group had 51 cases. The children of observation group were treated with 1 g/kg of IVIG in intravenous injection, the children of control group were treated with 2 g/kg of IVIG in intravenous injection, the curative effect of two kinds of treatment methods were comparative studied. The total heat process, antifebrile time, mucosal hyperemia, brothers swelling and cervical lymph gland enlargement subsidise time were observed, the peripheral white blood count, platelet count, Cre-acting protein, erythrocyte sedimentation rate and coronary artery lesion occurrence were monitored. Results The hospital stays, antifebrile time, mucosal hyperemia, brothers swelling and cervical lymph gland enlargement subsidise time, and the total heat process of two groups were comparied, the differences between the two groups weren't significant (P > 0.05); the WBC, PLT, CRP, ESR of two groups were significantly reduced compared with before treatment (P < 0.05), bul the differences between the two groups weren't significant (P > 0.05). The CAL rate in observation group was 25.5%, the CAL rate in control group was 21.6%, the difference between the two groups wasn't significant (P > 0.05). Conclusion IVIG 1 g/kg intravenous single injection treatment of Kawasaki disease can effectively relieve symptoms, reduce the incidence of CAL, compared with 2 g/kg of IVIG, the treatment effect is similar.