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  

Effects of Different dose of Immunoglobulin for Children with Kawasaki disease and Effect on Coronary Artery Lesion

作　　者：刘芳[1] 陈嫕[2] 秦蔚[1] 张慧[1] 

机构地区：[1]上海同济大学附属东方医院儿科,上海200120 [2]上海交通大学医学院附属新华医院儿科,上海200092

出　　处：《中国医药指南》2013年第13期20-21,共2页Guide of China Medicine

摘　　要：目的探讨静脉注射不同剂量丙种球蛋白(IVIG)对治疗川崎病的疗效及对冠状动脉病变的近期和远期影响。方法选取2008年3月至2009年10月期间在我院和新华医院儿科接受治疗的64例川崎病患儿,分为IVIG 1g/kg观察组与IVIG 2g/kg对照组,观察两种治疗方法的疗效,并对患儿进3年左右的随访,观察对冠状动脉病变的远期影响。结果两组患者退热时间、颈淋巴结肿大消退时间、黏膜充血、手足肿胀和总热程等情况基本相同;各项实验室检查结果与治疗前比较,两组患者血小板计数、血沉、外周血白细胞计数、C反应蛋白明显降低(P<0.05),两组间比较差异无显著性。随访两组对冠状动脉病变的远期影响无明显差异。结论治疗川崎病过程中应用丙种球蛋白1g/kg单次静脉注射,可起到与丙种球蛋白2 g/kg单次静脉注射治疗川崎病相似的效果,有效降低冠状动脉病变的发生率。Objective To investigate the effect of different doses of intravenous immunoglobulin in treatment of Kawasaki disease and effect on coronary artery lesion.Methods From 2008 March to 2009 October treated in our hospital and XinHua Hospital 64 cases of Kawasaki disease in children,were divided into IVIG 1g/kg observation group and IVIG 2g/kg control group,compared the effect of two kinds of treatment methods.Children with total duration of fever,neck lymph node swelling subsided,hand and foot swelling and membrane hyperaemia were observed,in addition shall also monitor coronary artery lesion,platelet count,white blood cell counts,C reactive protein and blood sedimentation occurred.And 3 years follow-up was done to observe remote effect of CAL in two groups.Results The cooling time,two groups of patients with cervical lymphadenopathy subsided,mucosal hyperemia,swelling of the hands and feet and total heat process is basically the same;the measurement,compared with before treatment,two groups of patients with platelet count,erythrocyte sedimentation rate,peripheral white blood cell count,C reaction protein decreased significantly（P〈0.05）.The difference was not significant for CAL follow-up in two groups.Conclusion The application of IVIG in 1 g/kg single intravenous injection in the treatment of Kawasaki disease process,can play with IVIG of 2 g/kg single intravenous injection in the treatment of Kawasaki disease similar effect,effectively reduce the incidence of coronary artery disease.

关 键 词：不同剂量 丙种球蛋白 川崎病 冠状动脉病变 影响 

分 类 号：R725.4[医药卫生—儿科]