静脉丙种球蛋白治疗川崎病三种疗法评估

Evaluation of the three modalitis with intravenous immunoglobulin infusion in treatment of Kawasaki disease

目的 探讨应用静脉丙种球蛋白（IVIG）治疗小儿川崎病（KD）三种疗法的效果。方法 收集1998-2004年间我院应用IVIG治疗川崎病患者76例，对4d疗法（0．4g／kg，连用4d）、2d疗法（1g／kg，连用2d）、1d疗法（2g／kg，用1d）进行疗效对比。结果 在发热消退、结膜充血恢复、口腔改变的恢复、血白细胞与血沉的恢复方面，1d疗法与2d疗法疗效显著，与4d疗法比较，差异有统计学意义（P〈0．01）；在颈淋巴结消退、C-反应蛋白的恢复方面，三种疗法比较，差异无统计学意义（P〉0．05）；在预防冠状动脉扩张（CAD）方面，1d疗法、2d疗法疗效显著，与4d疗法比较，差异有统计学意义（P〈0．01）。结论 1d疗法与2d疗法在疗效方面明显优于4d疗法，1d疗法输入蛋白量为2000mg／kg，会使患儿血浆胶体渗透压短时间内骤升，而2d疗法1d输入蛋白量为1000mg／kg，对小儿的血浆胶体渗透压影响较小，因此2d疗法更优于1d疗法。

Objective To evaluate effects of three modalities with intravenous immrnoglobulin （IVIG） infusion in the treatment of Kawasaki disease（KD）. Methods 76 KD cases were treated by the IVIG in the Deparment of Pediatric of Kaiping Central Hospital from 1998 to 2004. The three modalities were as follows： four days treatment（0.4 g/kg, for four days continuance）, two days treat- ment（1 g/kg, for two days continuance）, one day treatment（2 g/kg, for one day）. Results （1） In treatment of fever, conjunctiva congest and mouth change, and recover in white blood cell and erythrocyte sedimentation, one day treatment and two days treatment had better curative effects with significantly difference（ P 〈 0.01 ）, comparing with four days treatment. （2）In recover of cervical lymphadenitis and C-RP, there was no difference among the three modalities（P 〉 0.05）. （3） In the prevention of coronary artery dilate（CAD）, one day treatment and two days treatment had better curative effects significantly difference（P〈 0.01）comparing with four days treatment. Conclusions One day treatment and two days treatment have better curative effects, and the two days treatment is a much better modality with no change of osmotic pressure and less infusion of albumin in the treatment of children KD.