川崎病患儿IVIG抵抗调查及影响因素研究  

Study on IVIG resistance and influencing factors in children with Kawasaki disease

作　　者：王豪 何颜祥 李海啸 Wang Hao;He Yanxiang;Li Haixiao(Pediatrics Department of Kaifeng Children's Hospital,Kaifeng,Henan 475000,China)

机构地区：[1]开封市儿童医院儿科,河南开封475000

出　　处：《齐齐哈尔医学院学报》2025年第7期646-649,共4页Journal of Qiqihar Medical University

摘　　要：目的 调查川崎病(KD)患儿静脉注射用丙种球蛋白(IVIG)抵抗情况并分析其影响因素。方法 选择2021年3月—2024年2月本院收治的152例KD患儿为研究对象,调查患儿IVIG抵抗情况,根据是否对IVIG抵抗分为IVIG抵抗组、IVIG应答组,比较两组两组患儿一般资料、临床特征及实验室指标[红细胞沉降率(ESR)、白细胞计数(WBC)、血小板计数(PLT)、血钠、血清白蛋白(ALB)、铁蛋白(SF)、C反应蛋白(CRP)、白细胞介素-6(IL-6)],采用Logistic回归分析IVIG抵抗的独立影响因素。结果 152例患儿在发病10 d内接受2 g/kg剂量的IVIG治疗,共有31例患儿对IVIG治疗产生抵抗,发生率为20.39%,纳入IVIG抵抗组,其余纳入IVIG应答组;IVIG抵抗组与IVIG应答组患儿年龄、性别、临床症状、发热至使用IVIG的时间比较,差异均无统计学意义(P>0.05);IVIG抵抗组与IVIG应答组ESR、WBC、血钠水平比较,差异均无统计学意义(P>0.05),IVIG抵抗组PLT、SF、CRP、IL-6水平均高于IVIG应答组,ALB水平低于IVIG应答组,差异有统计学意义(P<0.05);Logistic多因素回归分析显示,ALB、SF、CRP、IL-6均为IVIG抵抗的独立影响因素(P<0.05)。结论 KD患儿IVIG抵抗与ALB、SF、CRP、IL-6密切相关,可作为预测IVIG抵抗的独立因素,为临床提供参考依据。Objective To investigate the resistance of intravenous gamma globulin(IVIG)in patients with Kawasaki disease(KD)and analyze its influencing factors.Methods A total of 152 children with KD admitted to our hospital from March 2021 to February 2024 were selected as the subjects of this study,and were divided into IVIG resistance group and IVIG response group based on the resistance to IVIG.General data,clinical characteristics and laboratory indicators[erythrocyte sedimentation rate(ESR),white blood cell count(WBC),platelet count(PLT),blood sodium,serum albumin(ALB),ferritin(SF),C-reactive protein(CRP),interleukin-IL-6(IL-6)]were compared and Logistic regression analysis was used to analyze independent factors affecting IVIG resistance.Results Among the 152 children with a 2 G/kg dose of IVIG within 10d of disease onset,31 children were resistant to IVIG therapy and the incidence rate was 20.39%,including in the IVIG resistance group.The rest were included in the IVIG response group.There was no statistically significant differences between IVIG resistant and IVIG response group based on age,sex,clinical symptoms,time from fever to IVIG respectively(P>0.05);there was no significance between the IVIG resistant and IVIG responsive groups based on ESR,WBC and blood sodium levels(P>0.05).The levels of PLT,SF,CRP,and IL-6 were all higher in the IVIG resistant group than in the IVIG responsive group;the ALB levels were lower than those in the IVIG response group(P<0.05).Logistic Multivariate regression analysis showed that ALB,SF,CRP,and IL-6 were all independent factors affecting IVIG resistance(P<0.05).Conclusions IVIG resistance in KD children is closely related to ALB,SF,CRP,and IL-6,which can be used as independent factors to predict IVIG resistance and provide a reference for clinical practice.

关 键 词：川崎病 丙种球蛋白抵抗 影响因素 LOGISTIC回归分析 

分 类 号：R725.4[医药卫生—儿科]