川崎病患儿初次接受IVIG联合阿司匹林治疗的疗效影响因素分析  

Analysis of influencing factors on the efficacy of IVIG combined with aspirin treatment in children with Kawasaki disease for the first time

作　　者：黄葆莹[1] 蒋苏华[1] 蒋威[1] 彭伟彬 HUANG Bao-ying;JIANG Su-hua;JIANG Wei(Department of Pediatrics,Statistics Office Foshan first people's Hospital,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院儿科,广东佛山528000

出　　处：《中国处方药》2023年第8期85-88,共4页Journal of China Prescription Drug

基　　金：佛山市科技创新项目(2020001004968)。

摘　　要：目的 探讨川崎病患儿初次接受大剂量丙种球蛋白(IVIG)联合阿司匹林治疗后无反应的独立危险因素。方法 将2018年7月~2021年8月在医院接受IVIG联合阿司匹林治疗的川崎病患儿纳入研究范围。根据静脉注射IVIG治疗的反应将纳入研究的153例患儿分为IVIG敏感组(n=138)和IVIG不敏感组(n=15)。对两组患儿一般情况、临床特点、实验室检查结果进行单因素分析,对有统计学意义的因素再进行多因素Logistic回归分析,明确IVIG无反应的独立危险因素。结果 与IVIG不敏感组比较,IVIG敏感组降钙素原(PCT)、血胆红素偏低,白蛋白(ALB)偏高,差异均有统计学意义(P <0.05)。多因素Logistic回归分析,血胆红素升高(OR=1.098,95%CI:1.025~1.175)及中性粒细胞比例升高(OR=1.081,95%CI:1.023~1.143)是川崎病患儿接受IVIG联合阿司匹林治疗无反应的独立危险因素。结论 血胆红素水平和中性粒细胞比例升高是川崎病患儿接受IVIG联合阿司匹林治疗无反应的独立危险因素。Objective To investigate the independent risk factors of non response in children with Kawasaki disease after initial treatment with high doses of immunoglobulin(IVIG) combined with aspirin.Methods Children with Kawasaki disease who received IVIG combined with aspirin treatment in hospitals from July 2018 to August 2021 were included in the study scope.According to the response to intravenous IVIG treatment,153children included in the study were divided into an IVIG sensitive group(n = 138) and an IVIG insensitive group(n = 15).Single factor analysis was conducted on the general situation,clinical characteristics,and laboratory test results of the two groups of children,and multivariate Logistic regression analysis was performed on statistically significant factors to identify independent risk factors for IVIG non response.Results Compared with the IVIG insensitive group,the IVIG sensitive group had lower Calcitonin(PCT) and serum bilirubin,and higher albumin(ALB),with statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that an increase in blood bilirubin(OR = 1.098,95%CI:1.025 ~ 1.175) and an increase in neutrophil ratio(OR = 1.081,95%CI:1.023 ~ 1.143) were independent risk factors for unresponsiveness in children with Kawasaki disease receiving IVIG combined with aspirin treatment.Conclusion The increase of serum bilirubin and the higher percentage of neutrophils are independent risk factors of non-response in children with of Kawasaki disease treated with IVIG and aspirin.

关 键 词：川崎病 丙种球蛋白 阿司匹林 IVIG无反应 危险因素 

分 类 号：R725.4[医药卫生—儿科]