不同剂量丙种球蛋白治疗对川崎病冠状动脉病变的影响

摘要

Objective:To observe the effects of different doses of gamma globulin (IVIG) on treatment of Kawasaki coronary artery disease (KD).Methods:74 cases of KD patients were randomly divided into 2 groups, children of low-dose group (n=36 patients) was injected IVIG ( 1g/kg) intravenously while children of high-dose group (n=38 patients) was injected IVIG ( 2g/kg) intravenously, and then the improved time of clinical symptoms and signs as well as coronary artery lesions (CAL) incidence were observed. Results:The clinical parameters of the two groups, including the course of fever, hospitalization time, pyretolysis time, regression time of mucosa hyperemia, regression time of hand andfoot swelling and regression time of cervical lymph node showed no significant difference (P>0.05);there was no significant difference on CAL incidence (27.8%vs 28.9%)between the two groups (P>0.05). Conclusion:Single intravenous injection treatment of IVIG (1g/kg ) had the same incidence of CAL compared with that of IVIg (2g/kg) ,and so clinically the 1g/kg IVIG should be considered as a preferred therapeutic dose.%目的：观察不同剂量丙种球蛋白(IVIG)治疗对川崎病(KD)冠状动脉病变的影响。方法：74例KD患儿随机分为2组，小剂量组(n=36例)患儿给予1g/kg IVIG静脉注射，大剂量组(n=38例)患儿给予2g/kg IVIG静脉注射，观察两组患儿临床症状体征改善时间和冠状动脉病变(CAL)发生率。结果：两组患儿总热程、住院治疗时间、退热时间、黏膜组织充血消退时间、手足肿胀消退时间及颈淋巴结肿大消退时间等各临床指标比较均无显著差异性(P>0.05)；两组患儿CAL发生率(27.8% vs 28.9%)比较无显著差异性(P>0.05)。结论：1g/kg IVIG单次静脉注射治疗与2g/kg IVIG疗效和CAL发生率相似，临床宜选择1g/kg IVIG作为首选治疗剂量。