不同剂量静脉滴注丙种球蛋白治疗川崎病临床疗效观

Clinical effective observation of different dose of intravenous immunoglobulin(Ig G)for treating Kawasaki disease

目的:观察丙种球蛋白治疗川崎病(KD)的临床疗效。方法:将108例患儿分为3组:A组46例,单服阿司匹林;B组32例,静脉滴注丙种球蛋白400 mg/(kg·d)连用3天,C组30例,予丙种球蛋白1g/kg单剂静脉滴注。B、C两组均同时联用阿斯司林,方法同A组。3组患儿其他用药基本一致。观察其退热时间、冠状动脉病变(CAD)发生率及其恢复时间。结果:A组平均退热时间(4.6±1.4)天,CAD的发生率为39.1%(18/46),CAD平均恢复时间为(149.7±16.5)天;B组平均退热时间(2.0±0.4)天,CAD发生率为18.8%(6/32),CAD平均恢复时间(81.5±22.5)天;C组病例平均退热时间(1.0±1.2)天,CAD的发生率为20.0%(6/30),CAD平均恢复时间为(60.3±13.8)天。结论:静脉滴注丙种球蛋白治疗KD能减少CAD的发生率,减少CAD的恢复时间,同时能减少KD的退热时间,且1 g/kg单剂静脉滴注较400 mg/(kg·d)连用3天更有效。

Objective：To investigate the curative effect of intravenous immunoglobulin （Ig G） for treating Kawasaki disease（KD）. Methods： 108 children patients were divided into 3 groups： 46 eases in group A took orally aspirin ordy,32 eases in group B were given intravenous immunoglobulin （Ig G） in a dose of 400 mg,/（kg, d） for continuous 3 d and 30 eases in group C were given immunoglobulin（Ig G） in a single dose of 1 g/kg for intravenous drip. B and C groups were simultaneously added aspirin with the same method in group A. Other used drugs in 3 groups were basically consistent. The defervescenee time, occurrence rate of coronary artery pathological change （CAD） and recovery time were investigated and compared in 3 groups. Results：The average defervescence time in group A was （4.6 ± 1.4）d,the occurrence rate of CAD was 39.1%（18/46）, the average recovery time was （149.7±16.5）d;those in group B were （2.0 ± 0.4）d, 18.8%（6/32）, （81.5±22.5）d,respectively;those in group C were （1.0 ± 1.2）d,20.0%（6/30）, （60.3 ~13.8）d,respeetively. Conclusion： Intravenous immunoglobulin（Ig G） for treating KD can reduce the occurrence rate of CAD, shorten the recovery time of CAD and decrease the defervescence time. A single dose of 1 g/kg by intravenous drip is more effective compared with 400 mg/（kg·d） for continuous 3 d.