静脉丙种球蛋白无反应性川崎病的危险因素分析  

Analysis of risk factors with refractory Kawasaki disease to gamma-globulin therapy

作　　者：张松跃[1] 张园海[1] 荣星[1] 任跃[1] 陈其[1] 项如莲[1] 

机构地区：[1]温州医学院附属第二医院小儿心血管科

出　　处：《中国临床药理学与治疗学》2011年第6期657-660,共4页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:探讨首次静脉注射丙种球蛋白(IVIG)无反应性川崎病(KD)的发病率及相关危险因素。方法:总结2005年1月至2010年12月温州医学院附属第二医院KD患儿的临床资料,IVIG无反应性KD定义为首次IVIG治疗无效,36 h后体温仍超过38.5℃,根据对首次大剂量IVIG有无反应分成IVIG敏感组和IVIG无反应组,比较两组的临床特点。结果:515例KD患儿纳入研究对象,其中IVIG敏感者476例,IVIG无反应者39例,发生率为7.57%(39/515)。Logistic回归分析发现血白细胞、血红蛋白、C反应蛋白(CRP)、血沉、ALT、白蛋白及IVIG用药方案是IVIG无反应性的独立危险因素(P<0.05)。结论:7.57%KD患儿对初次IVIG治疗无反应。血白细胞、血红蛋白、CRP、血沉、ALT、白蛋白及IVIG用药方案是IVIG无反应的独立危险因素。AIM：To investigate the incidence and risk factors of children with refractory Kawasaki disease（KD）. METHODS： Clinical data of KD patients hospitalized in the Second Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2010 were summarized.Refractory KD was defined as those who remained febrile with a temperature of 38.5 ℃ for 36 hours after initial intravenous immunoglobulin treatment.All KD patients were divided into two groups,responsiveness group and non-responsiveness group,based on their response to the first high dose IVIG therapy.RESULTS：Total 515 KD patients treated with high dose IVIG were included.The incidence of non-responsiveness to IVIG therapy is 7.57%（39/515）.Logistic regression revealed that white blood cell（WBC）,hemoglobin,C-reactive protein（CRP）,erythrocyte sedimentation rate（ESR）,alanine aminotransferase（ALT）,serum albumin and IVIG dosage were independent risk factors for refractory KD（P0.05）.CONCLUSION： The incidence of refractory KD is 7.57%.WBC,hemoglobin,CRP,ESR,ALT,serum albumin and IVIG dosage can predict the occurrence of refractory KD.

关 键 词：川崎病 丙种球蛋白 静脉注射 无反应 危险因素 

分 类 号：R543.6[医药卫生—心血管疾病]