采用不同方法治疗不同年龄川崎病患儿的疗效分析

Therapeutic Efficacy Analysis of Kawasaki Disease with Different Ages and Different Therapy

目的探讨采用不同方法治疗川崎病(KD)的短期治疗效果,以及不同年龄患儿的治疗效果。方法回顾性分析2006年1月-2008年5月曾于本院住院治疗的68例KD患儿,首先按照静脉用丙种球蛋白(IVIG)的不同应用方法(2g/kg用1d或1g/kg连用2d)分为2组,应用SPSS12.0软件进行组间比较:包括临床症状消退时间、外周血WBC、CRP、ESR及冠状动脉病变恢复情况;另将68例患儿根据不同的年龄阶段(<3岁,3～5岁,>5岁)分为3组,亦采用SPSS12.0软件进行组间比较。结果应用不同的IVIG治疗方案后,各种主要临床症状包括发热、眼结膜充血、唇干裂、皮疹、手足肿胀、颈淋巴结大消退时间,以及血WBC、CRP、ESR、冠状动脉病变恢复情况,2组间比较均无统计学差异;对于不同年龄段的KD患儿,治疗前各组间上述临床症状消退时间、WBC及CRP恢复时间均无统计学差异,而用药2周后ESR的下降率及冠状动脉恢复情况,>5岁组显著差于其余2组。结论KD急性期应用不同IVIG方法其短期内治疗效果无显著性差异;而不同年龄患儿在治疗过程中呈现不同的治疗效果,5岁以下患儿短期效果相对较好。

Objective To approach the short - term therapeutic efficacy of Kawasaki disease （KD） by different therapy, and the efficacy in different age. Methods Retrospective analyze 68 children in the First Affiliated Hospital of Sun Yat - Sen University from Jan. 2006 to May 2008. First,68 children were divided into 2 groups according to different administration of intravenous immuno - glublin （IVIG） ,2 g/kg for 1 d or 1 g/（ kg · d） for 2 days,respectively, then compare the recovery time of clinical symptom, the peripheral white blood cells （WBC）, C - reactive protein（ C RP）, erythrocyte sedimentation rate （ESR） and the recovery of coronary artery with each other by SPSS 12.0 software. Then, according to different ages the 68 children were divided into 3 groups： 〈3 years,3 -5 years, 〉5 years, to compare the above indexes again during the groups also by SPSS 12.0 software. Results With different IVIG use, there were no statistical difference between the 2 groups in the recovery time including fever, eonjunctival congestion, chilo - rhagades, rash, acro - swell,lymphadenectasis, and the recovery of WBC, CRP, ESR after 2 weeks＇ therapy, the coronary artery. While to children of different ages, there were also no statistical difference in the recovery of above clinical indexes, WBC and CRP, but in the descending rate of ESR and the recovery of coronary artery, 〉 5 years group was worse than those in the other 2 groups. Conclusions The IVIG administration in KD, 2 g/kg used for 1 d or 1 g/（ kg · d） for 2 d, makes no statistical different efficacy. There＇s different efficacy in children with different ages, and the short -term efficacy tends to be better in children younger than 5 years.