静脉注射丙种球蛋白对无反应性川崎病的治疗及危险因素分析

摘要

Objective To explore the IVIG non-reactivity with treatment and risk factors .Methods Selected 70 cases in June 2012 to June 2013 of the hospitalized children with kawasaki disease , were given aspirin with IVIG therapy , and was sensitive to initial IVIG treatment response and data analysis , the risk factors to initial IVIG treatment with no response .Results 59 cases of initial IVIG treatment sensitive , 11 cases of treatment for the first time with no response;Second 1 g/kg of IVIG therapy , 2 times of 2 g/kg of IVIG and 400~600 mg/kgIVIG treatment efficient significant differences (P<0.05);To use IVIG days, WBC, CRP levels rising, ALT, blood sedimentation , propagated , Hb reducing , and the rapid treatment was IVIG non-reactive independent risk factors (P <0.05).Conclusions IVIG days, WBC, CRP levels rising, ALT, blood sedimentation, propagated , Hb reducing , and the rapid first IVIG treatment have no reaction with independent factors , can be used on the treatment of kgIVIG by the second 2 g/2 dose.%目的：探讨IVIG无反应性患儿再治疗方案及危险因素。方法选取70例于2012年6月至2013年6月期间我院接收的川崎病住院患儿，均给予阿司匹林联合IVIG治疗，并对初始IVIG治疗无反应及敏感者资料进行分析，观察初始IVIG治疗无反应危险因素。结果59例初次IVIG治疗敏感，11例首次治疗无反应；接受第2次1 g／kg的IVIG治疗、2次2 g／kg的IVIG及400～600 mg／kg IVIG治疗的患者有效率存在显著差异（ P＜0．05）；发病至用IVIG天数、WBC、CRP增加、ALT上升、血沉增快、ALB、Hb减低及治疗方案是IVIG无反应性的独立危险因素（P＜0．05）。结论发病至用IVIG天数、WBC、CRP增加、ALT上升、血沉增快、ALB、Hb减低及治疗方案是初次IVIG无反应患儿的独立因素，在治疗上可使用第2剂2 g／kg IVIG治疗。