糖皮质激素联合静脉输注丙种球蛋白治疗静脉输注丙种球蛋白无反应型川崎病患儿的临床疗效  

Clinical efficacy of glucocorticoids combined with intravenous immunoglobulin in the treatment of children with intravenous immunoglobulin unresponsive Kawasaki disease

作　　者：苏然 周婷[1] 杨宁[1] SU Ran;ZHOU Ting;YANG Ning(Department of Pediatrics,Changping District Teaching Hospital,Capital Medical University,Beijing,102200,China)

机构地区：[1]首都医科大学昌平区教学医院儿科,北京102200

出　　处：《当代医学》2024年第2期149-153,共5页Contemporary Medicine

摘　　要：目的探究糖皮质激素联合静脉注射丙种球蛋白(IVIG)治疗IVIG无反应型川崎病(KD)患儿的临床疗效。方法选取2019年1月至2021年12月首都医科大学昌平区教学医院儿科接诊的60例IVIG无反应型KD患儿作为研究对象,按照随机抽签法分为对照组与观察组,各30例。对照组给予IVIG治疗,观察组给予糖皮质激素联合IVIG治疗。比较两组临床疗效、实验室指标、病情恢复情况、冠状动脉损伤情况。结果观察组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05);用药7 d后,两组WBC、超敏C反应蛋白(hs-CRP)、红细胞沉降率(ESR)均低于用药前,血小板计数(PLT)高于用药前,且观察组WBC、ESR、hs-CRP水平均低于对照组,PLT高于对照组,差异有统计学意义(P<0.05);观察组总热程、退热时间均短于对照组,冠状动脉损伤发生率低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较差异无统计学意义。结论糖皮质激素联合IVIG治疗IVIG无反应型KD患儿效果显著,有助于控制患儿炎症反应,保护冠状动脉,减少损伤程度,且安全可靠,值得临床推广应用。Objective To investigate the clinical efficacy of glucocorticoids combined with intravenous immunoglobulin(IVIG)in the treatment of children with IVIG unresponsive Kawasaki disease(KD).Methods 60 children with IVIG unresponsive KD admitted to the Pediatrics department of Changping District Teaching Hospital,Capital Medical University from January 2019 to December 2021 were selected as the study subjects,and they were divided into the control group and the observation group according to the random number table method,with 30 cases in each group.The control group was treated with IVIG,while the observation group was treated with glucocorticoids combined with IVIG,the clinical efficacy,laboratory indicator,disease recovery,and coronary artery injury were compred between two groups.Results The total effective rate in the observation group was 93.33%,which was higher than 73.33% in the control group,and the difference was statistically significant(P<0.05);after 7 d of medication,the levels of WBC,hypersensitive C-reactive protein(hs-CRP),erythrocyte sedimentation rate(ESR)of the two groups were lower than before medication,while blood platelets(PLT)were higher than before medication,and the levels of WBC,ESR,and hs-CRP in the observation group were lower than those in the control group,and PLT was higher than that in the control group,and the differences were statistically significant(P<0.05);the total fever duration and antipyretic time in the observation group were shorter than those in the control group,and the incidence of coronary artery injury was lower than that in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups.Conclusion Glucocorticoids combined with IVIG has significant therapeutic effect on children with IVIG unresponsive KD,which helps to control inflammation,protect coronary arteries from damage,and is safe and reliable,it is worthy of clinical promotion and applicati

关 键 词：川崎病 静脉注射丙种球蛋白 糖皮质激素 冠状动脉损伤 

分 类 号：R725.4[医药卫生—儿科]