丙种球蛋白应用时间对川崎病患儿退热时间以及冠状动脉损伤的影响  

The effect of application time of intravenous immune globulin on fever clearance time and coronary artery lesion for Kawasaki disease

作　　者：闵锋[1] 朱少元 李娇春 

机构地区：[1]天门市第一人民医院儿科,湖北天门431700

出　　处：《东南大学学报（医学版）》2016年第1期50-53,共4页Journal of Southeast University(Medical Science Edition)

摘　　要：目的：探讨丙种球蛋白应用时间对川崎病患儿退热时间以及冠状动脉损伤的影响。方法：回顾性分析我院2010年1月至2014年1月收治的120例川崎病患儿的临床资料,按静脉用丙种球蛋白（IVIG）应用时间分作早期组（发病后1~4 d内应用）30例、常规组（发病后5~9 d内应用）50例、晚期组（发病后≥10 d应用）40例。比较各组患儿的退热时间与冠状动脉病变发生率。结果：治疗后3组患儿皮疹、结膜炎、淋巴结炎、手足肿胀等症状的持续时间差异均无统计学意义（P〉0.05）,退热时间差异也无统计学意义（P〉0.05）。常规组冠状动脉病变发生率（12.0%）略低于早期组（13.33%）,差异无统计学意义（P〉0.05）,晚期组冠状动脉病变的发生率最高（16.0%）,与其他两组相比,差异有统计学意义（P〈0.05）。早期组患儿丙种球蛋白无反应率（73.33%）明显高于常规组（34.0%）,常规组明显高于晚期组（22.50%）,差异均有统计学意义（P〈0.05）。结论：川崎病患儿在发病后5~9 d开始应用丙种球蛋白,冠状动脉病变发生率低,丙种球蛋白无反应发生率低,推测此阶段可能是应用丙种球蛋白的最好时机。Objective：To investigate the effect of application time of intravenous immune globulin（IVIG） on fever clearance time and coronary artery lesion for Kawasaki disease. Methods：Clinical data of 120 cases of Kawasaki disease children admitted in our hospital from January 2010 to January 2014 were retrospectively analyzed,they were divided into early group （IVIG was applied in 1 to 4 days after morbidity） 30 cases, the conventional group （IVIG was applied in 5 to 9 days after morbidity） 50 cases and flate group （IVIG was applied more than 10 days after morbidity） 40 cases according to the application time of IVIG. Results：The duration of symptoms in three groups of children with rash,conjunctivitis, lymphadenitis, foot swelling showed no significant difference （P〉0.05）, fever clearance time had no significant difference among three groups（P〉0.05）. Incidence of coronary artery disease in conventional group （12.0%） was slightly lower than the early group （13.33%）,there was no statistically significant difference, the incidence of coronary artery disease in the late group was the highest （15.0%）, there was statistically significant difference compared with the other two group （P〈0.05）. Gamma globulin no reaction rate of early group（73.33%） was higher than conventional group （34.0%）, conventional group（34.0%） was higher than late group （22.50%）,there were statistically significant difference（P〈0.05）. Conclusion：Applying IVIG to treat Kawasaki disease children in 5 to 9 days after morbidity has low incidence of coronary artery disease and low gamma globulin no reaction rate,suggesting that this phase may be best time for the application of gamma globulin.

关 键 词：丙种球蛋白 川崎病 冠状动脉损伤 

分 类 号：R725.4[医药卫生—儿科]