小剂量糖皮质激素在静脉注射免疫球蛋白无反应型川崎病患儿中的应用效果  

Efficacy of Low-dose Glucocorticoids in Children with Intravenous Immunoglobulin-resistant Kawasaki Disease

作　　者：庄一波 潘骞 符辰潞[1,2] Zhuang Yibo;Pan Qian;Fu Chenlu(Department of Pediatrics,Changzhou First People's Hospital1,Changzhou 213003,Jiangsu Province,China;Department of Neonatology,Changzhou First People's Hospital2,Changzhou 213003,Jiangsu Province,China)

机构地区：[1]常州市第一人民医院儿科,江苏常州213003 [2]常州市第一人民医院新生儿科,江苏常州213003

出　　处：《中外医药研究》2025年第8期81-83,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探究小剂量糖皮质激素在静脉注射免疫球蛋白(IVIG)无反应型川崎病患儿中的应用效果。方法:根据随机数字表法,将常州市第一人民医院儿科2020年5月—2023年6月住院治疗的61例IVIG无反应型KD患儿分为对照组(接受再次IVIG冲击治疗,30例)和观察组(在对照组基础上增加小剂量甲泼尼龙琥珀酸钠联合醋酸泼尼松片治疗,31例)。对比两组炎性因子及脑钠肽(BNP)水平、冠状动脉损伤情况以及不良反应发生率。结果:治疗后,两组肿瘤坏死因子-α、白细胞介素-6、C反应蛋白、BNP水平降低,观察组低于对照组(P<0.05);治疗后6、12个月,观察组冠状动脉损伤率低于对照组(P<0.05)。观察组不良反应发生率低于对照组(P=0.043)。结论:大剂量IVIG冲击治疗基础上,联合应用小剂量甲泼尼龙琥珀酸钠、醋酸泼尼松片,可降低IVIG无反应型KD患儿的炎性因子、BNP水平及冠状动脉损伤率,不良反应较少。Objective:To evaluate the efficacy of low-dose glucocorticoids in children with intravenous immunoglobulin(IVIG)-resistant Kawasaki disease.Methods:Sixty-one children with IVIG-resistant Kawasaki disease admitted to Changzhou First People's Hospital from May 2020 to June 2023 were randomized into a control group(n=30,receiving repeat IVIG therapy)and an observation group(n=31,additional low-dose methylprednisolone sodium succinate and prednisone acetate tablets on the basis of the control group).Inflammatory markers,brain natriuretic peptide(BNP),coronary artery lesions,and adverse reactions were compared.Results:After treatment,the levels of tumor necrosis factor-α,interleukin-6,C-reactive protein and BNP in the two groups were decreased,and those in the observation group were lower than those in the control group(P<0.05).At 6 and 12 months after treatment,the incidence of coronary artery injury in the observation group was lower than that in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P=0.043).Conclusion:The adjunctive use of low-dose methylprednisolone sodium succinate and prednisone acetate tablets in combination with high-dose IVIG pulse therapy reduces inflammatory factors,BNP levels,and coronary artery lesion rates in IVIG-resistant Kawasaki disease patients,with fewer adverse reactions.

关 键 词：甲泼尼龙琥珀酸钠 静脉注射免疫球蛋白 川崎病 炎性因子 脑钠肽 

分 类 号：R725.4[医药卫生—儿科]