甲基泼尼松龙治疗川崎病23例临床分析

Methylprednisolone treatment of 23 cases of kawasaki disease

目的:探讨甲基泼尼松龙治疗川崎病的临床疗效。方法:将46例川崎病患儿随机分为观察组和对照组各23例,对照组采用丙种球蛋白+阿司匹林治疗,观察组在对照组的基础上加用甲基泼尼松龙治疗,比较两组疗效及不良反应。结果:46例患儿均痊愈或好转,观察组3d内退热者23例(100.00%),对照组3d内退热者20例(89.96%),两组比较,差异有统计学意义(P<0.05);两组在治疗后白细胞(WBC)、血小板(PLT)、C反应蛋白(CRP)、血沉(ESR)值均明显下降,组间比较,差异有统计学意义(P<0.05);观察组治疗后21d及3个月后的冠状动脉病变发生率分别为13.04%和4.35%,对照组分别为30.43%和17.39%,组间比较,差异有统计学意义(P<0.05)。结论:川崎病是一种病因及发病机制目前尚未完全明确的全身性血管炎性疾病,在采用大剂量丙种球蛋白+阿斯匹林联合治疗的基础上,短期静脉使用甲基泼尼松龙可有效缩短病程,减少冠状动脉病变的发生。

Objective：To investigate the clinical efficacy of methylprednisolone in the treatment of kawasaki disease.Methods：46 patients with kawasaki disease were randomly divided into observation group and control group,23 cases in control group were treated with gamma globulin ＋ aspirin therapy,the observation group added methylprednisolone treatment based on the control group,efficacy and adverse reactions were compared.Results：46 cases of children were cured or improved,23 patients（100.00%） were defervesced within 3 d in observation group,20 patients（89.96%） were defervesced within 3 d in control group,the two groups had significant difference（P0.05）;two groups after treatment,WBC,PLT,CRP,ESR values were significantly decreased between the two groups,there were significant difference（P0.05）;After 21 d and 3 months treatment,the coronary artery disease rates in observation group were 13.04% and 4.35%,in the control group were 30.43% and 17.39%,there were significant differences between the two groups（P0.05）.Conclusion：Kawasaki disease is a kind of systemic vascular inflammatory disease which cause and pathogenesis is not yet completely clear,on the base of the high-dose gamma globulin ＋ aspirin combination therapy,short-term intravenous methylprednisolone can effectively shorten the course,reduce the incidence of coronary artery disease.