两种大剂量静脉注射丙种球蛋白对KD患儿的临床疗效  

Clinical analysis of two large dose intravenous immunoglobulins injection for KD children

作　　者：尚玉博 SHANG Yu-bo(The Second People＇s Hospital of Fuxin city （Fuxin Pediatric Maternity Hospital, Fuxin, Liaoning 123000, China)

机构地区：[1]阜新市第二人民医院(阜新市妇产医院)儿科,辽宁阜新123000

出　　处：《热带医学杂志》2017年第10期1362-1364,共3页Journal of Tropical Medicine

摘　　要：目的对比1 g/(kg·d)大剂量静脉注射丙种球蛋白1 d和2 d两种方案对标危川崎病患儿的临床治疗效果,分析研究优选方案。方法选取2014年9月至2016年9月在本院治疗的标危川崎病的患儿共262例,分为两个组,每组131名,其中A组为1 g/(kg·d)注射丙种球蛋白1 d,B组为1 g/(kg·d)连续2 d静脉注射丙种球蛋白组,对比两组患儿的住院天数、各时间段体温及退热情况、冠状动脉是否受到损害、淋巴及粘膜症状消退情况。结果A、B两组患儿在本院治疗期间体温恢复正常、淋巴及粘膜症状消退,达到预期效果,横向对比分析两组数据,A组患儿住院天数为(13.75±3.45)d,热程天数为(2.3±0.5)d;B组患儿住院天数为(13.50±3.70)d,热程天数为(2.7±0.4)d,两组差异无统计学意义(P>0.05);纵向对比分析患儿治疗后及治疗前各项数据,C-反应蛋白、外周血白细胞计数、红细胞沉淀率、血小板计数均恢复至正常值,治疗前后差异有统计学意义(P<0.05)。结论采用单次和连续2 d静脉注射丙种球蛋白1 g/(kg·d)具同等效果,1 g/(kg·d)静脉注射丙种球蛋白1 d费用较低,为最优方案。Objective To compare the efficacy of 1 g（/kg·d）single use and 1 g（/kg·d）with two days of two large doses of intravenous gamma globulin in the standard treatment of children with Kawasaki disease and optimize the treatment.Methods A total of 262 patients with Kawasaki disease were enrolled in our hospital from September 2014 to present. They were randomly divided into two treatment groups（131 in each group）：group A（1 g（/kg·d）,single injection）,group B（1 g（/kg·d）,injection for 2 consecutive days）. The treatment data of the two groups were collected;length of hospital stay,the temperature of each period of time and fever,coronary artery damage,lymphatic and mucosal symptoms subsided were compared between the two groups.Results In group A and B,the body temperature returned to normal,the lymphatic and mucosal symptoms subsided,and the expected results were achieved. The length of hospital stay in group A and B were（13.75±3.45）days and（13.50±3.70）days,respectively;the number of days of fever in group A and B were（2.3±0.5）and（2.7±0.4）,respectively. There were no significant differences in the length of hospital stay and the number of days of fever（P〉0.05）. C-reactive protein,peripheral white blood cell count,erythrocyte sedimentation rate and platelet count returned to normal values;there was significant difference before and fter treatment（P〈0.05）. Conclusion 1 g/kg intravenous injection of gamma globulin could achieve the same effect as 1 g（/kg·d） intravenous injection of gamma globulin for two consecutive days;1 g（/kg·d） single intravenous immunoglobulin should be the optimal treatment.

关 键 词：大剂量静脉注射 丙种球蛋白 标危川崎病 儿童 

分 类 号：R725.9[医药卫生—儿科]