阿司匹林联合大剂量丙种球蛋白治疗小儿川崎病的疗效及对血清脑利钠肽指标的影响

摘要

Objective:Explore the effect of aspirin combined with high dose of intravenous immunoglobulin in treatment of chil-dren with kawasaki disease and its effects on serum brain natriuretic peptide index.Methods:100 cases of Kawasaki disease were se-lected,and randomly divided into observation group and control group,each group had 50 cases.On the basis of the same dose of aspirin treatment,the observation group had given high-dose gamma globulin (1 g/kg) intravenous injection,while the control group received conventional dose (400 mg/kg).The serum levels of brain natriuretic peptide(BNP) and inflammatory markers,the improvement time of clinical symptoms and signs,the clinical efficacy and the incidence of cardiovascular complications were compared between the two groups.Results:The levels of BNP,CRP,ESR and PLT in the observation group were significantly lower than those in the control group,the difference was statistically significant (P<0.05).The recovery time of fever,mucosal hyperemia,swelling of lymph node in neck and foot scleredema in observation group were significantly shorter than that in the control group,the difference was statistically significant(P<0.05).The total clinical effective rate (94.0%) in observation group was higher than the effective rate(80.0%) in control group,the difference was statistically significant(χ2=5.892,P=0.014).The incidence of cardiovascular complications (8%) was lower than the incidence (24%) in the control group,the difference was statistically significant(χ2=6.23,P=0.011).Conclu-sion:Aspirin combined with large dose of intravenous immunoglobulin for children with Kawasaki disease can effectively reduce serum inflammatory markers and BNP level,shorten the recovery time of symptoms,improve clinical efficiency,reduce the incidence of cardio-vascular complications,is worthy of clinical application.%目的:探究阿司匹林联合大剂量丙种球蛋白静脉注射治疗小儿川崎病的疗效及对患儿血清脑利钠肽(brain natri-uretic peptide,BNP)指标的影响.方法:选取川崎病患儿100例,随机分为观察组和对照组,每组各50例.在相同剂量阿司匹林治疗基础上,观察组采取大剂量丙种球蛋白(1 g/kg)静脉注射,对照组采取常规剂量(400 mg/kg).对比两组患儿BNP及炎症指标水平、临床症状体征改善时间、临床疗效及心血管并发症发生率.结果:观察组患儿BNP、C反应蛋白(CRP)、血沉(ESR)及血小板计数(PLT)水平低于对照组,差异有统计学意义(P<0.05);观察组患儿发热、黏膜充血、颈部淋巴结肿大及手足硬肿等症状体征恢复正常时间均较对照组明显缩短,差异有统计学意义(P<0.05);观察组临床总有效率为94.0%,对照组临床总有效率为80.0%,差异有统计学意义(χ2=5.892,P=0.014);观察组患者心血管并发症发生率(8.0%)低于并发症发生率(24.0%),差异有统计学意义(χ2=6.23,P=0.011).结论:阿司匹林联合大剂量丙种球蛋白用于小儿川崎病能够有效降低血清炎症指标及BNP水平,缩短症状恢复时间,提高临床有效率,降低心血管并发症发病率,值得临床推广.