不同剂量丙种球蛋白治疗儿童川崎病的临床效果分析  

Clinical effect analysis of different doses of gamma globulin in the treatment of Kawasaki disease in children

作　　者：周培明 ZHOU Pei-ming(Department of Pediatrics,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362200,China)

机构地区：[1]福建省医科大学附属泉州市第一医院儿科,362200

出　　处：《中国现代药物应用》2023年第16期31-34,共4页Chinese Journal of Modern Drug Application

摘　　要：目的观察不同剂量丙种球蛋白治疗儿童川崎病的临床效果。方法86例川崎病患儿,按照随机原则分为甲组和乙组,每组43例。甲组给予单次剂量1.0 g/kg丙种球蛋白静脉滴注,乙组给予单次剂量2.0 g/kg丙种球蛋白静脉滴注,10~12 h内滴完。比较两组患儿症状消退时间、临床疗效及血清学检查指标[白细胞计数(WBC)、C反应蛋白(CRP)、红细胞沉降率(ESR)、血小板计数(PLT)]。结果乙组患儿高热、黏膜充血、手足硬肿、颈淋巴结肿大、皮疹消退时间分别为(1.06±0.31)、(2.04±1.21)、(2.15±1.06)、(2.11±1.02)、(2.13±1.01)d,均短于甲组的(2.91±0.87)、(3.97±1.03)、(4.43±1.09)、(3.97±1.29)、(4.28±1.26)d,差异具有统计学意义(P<0.05)。乙组患儿治疗总有效率为95.35%,高于甲组患儿的74.42%,差异具有统计学意义(P<0.05)。经丙种球蛋白治疗后36 h,乙组患儿的WBC、CRP、ESR、PLT分别为(7.14±2.12)×10^(9)/L、(20.57±2.92)mg/L、(49.87±2.84)mm/h、(373.62±80.29)×10^(9)/L,均低于甲组的(8.37±2.07)×10^(9)/L、(24.99±3.85)mg/L、(54.12±3.19)mm/h、(419.58±80.19)×10^(9)/L,差异具有统计学意义(P<0.05)。结论采用1.0、2.0 g/kg单次剂量的丙种球蛋白静脉滴注治疗儿童川崎病均能达的一定效果,相比之下高剂量用药能更明显减轻患儿症状,控制病情进展,疗效更好,值得推广。Objective To observe the clinical effect of different doses of gamma globulin in the treatment of Kawasaki disease in children.Methods A total of 86 children with Kawasaki disease were randomly divided into group A and group B,with 43 cases in each group.Group A was given a single dose of 1.0 g/kg of gamma globulin intravenously,and group B was given a single dose of 2.0 g/kg of gamma globulin intravenously,which was dosed within 10-12 h.The regression time of disease symptoms,clinical efficacy and serological indexes[white blood cell count(WBC),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),platelet count(PLT)].Results In group B,the remission time of high fever,mucosal congestion,stiff edema of hands and feet,lymphadenectasis of neck and rash were(1.06±0.31),(2.04±1.21),(2.15±1.06),(2.11±1.02)and(2.13±1.01)d,which were shorter than those of(2.91±0.87),(3.97±1.03),(4.43±1.09),(3.97±1.29)and(4.28±1.26)d in group A,and the differences were statistically significant(P<0.05).The total effective rate of group B was 95.35%,which was higher than that of 74.42%of group A,and the difference was statistically significant(P<0.05).At 36 h after gammaglobulin treatment,WBC,CRP,ESR and PLT of children in group B were(7.14±2.12)×10^(9)/L,(20.57±2.92)mg/L,(49.87±2.84)mm/h and(373.62±80.29)×10^(9)/L,which were lower than those of(8.37±2.07)×10^(9)/L,(24.99±3.85)mg/L,(54.12±3.19)mm/h and(419.58±80.19)×10^(9)/L in group A,and the differences were statistically significant(P<0.05).Conclusion 1.0 g/kg and 2.0 g/kg of gamma globulin intravenously can achieve a certain effect in the treatment of Kawasaki disease in children.High dose of medication can significantly reduce the symptoms of children,control the progress of the disease,the effect is better,which is worth promoting.

关 键 词：川崎病 儿童 冠状动脉病变 丙种球蛋白 效果 

分 类 号：R725.4[医药卫生—儿科]