丙种球蛋白治疗川崎病量效关系探讨

Clinical Efficacy Research of Different Dose Gamma Globulin in Curing Kawasaki Disease

目的探讨丙种球蛋白治疗川崎病的量效关系,为川崎病的临床治疗提供参考。方法选择104例川崎病患儿,随机分为A、B、C三组,均给予丙种球蛋白治疗,A组给予2g/kg单次静脉滴注;B组给予2g/kg静脉注射,每天1次,共2次;C组给予静脉滴注0.5g/(kg·d),连用4d。比较三组患者症状缓解时间、冠状动脉并发症及复发情况、血液学检查指标。结果 A组、B组临床症状缓解时间短于C组(P<0.05),冠状动脉并发症发生率及复发率低于C组(P<0.05);A组、B组临床症状缓解时间、冠状动脉并发症发生率及复发率相比,无显著性差异(P>0.05)。三组治疗前红细胞(WBC)、血小板(PLT)、血沉(ESR)及C反应蛋白(CRP)水平无显著性差异,治疗1周后A组、B组WBC、PLT、ESR及CRP水平低于C组(P<0.05),A组和B组WBC、PLT、ESR及CRP水平经比较无显著性差异(P>0.05)。结论丙种球蛋白单次足剂量给药治疗川崎病具有较好的临床疗效,增加剂量及延长治疗周期并不能改善临床疗效。

OBJECTIVE To investigate correlation between dosage and curative effect of gamma globulin in Kawasaki Disease（KD）, and provide reference for clinical treatment of KD. METHODS 104 cases of children patients with KD were selected and randomized into A, B and C groups, all patients taken treatment with gamma globulin, child patients in A groups taken gamma globulin with 2 g/kg in one time, child patients in B groups taken gamma globulin with 2 g/kg in two time, child patients in C groups taken gamma globulin with 0.5 g/kg in one time and was administed four days, time of clinical symptomatic relief, incidence rate of coronary artery complication and relapse, indicatrix of blood detecting were contrasted along A, B and C groups. RESULTS Time of clinical symptomatic relief was shorter in A and B groups than in C groups（P〈0.05）,incidence rate of coronary artery complication and relapse was lower in A and B groups than in C groups（P〈0.05）, time of clinical symptomatic relief, incidence rate of coronary artery complication and relapse was identical between A and B groups（P〉0.05）, before treatment, level of WBC, PLT, ESR and CRP was identical along A, B and C groups（P〉 0.05）, at one week after treatment, level ofWBC, PLT, ESR and CRP was lower in A and B groups than in C groups （P〈0.05）, level of WBC, PLT, ESR and CRP was identical between A and B groups（P〉0.05）. CONCLUSION Gamma globulin with sufficient dose in once could obtain good clinical effect, increasing dose and lengthening course of treatment was not helpful for improving curative effect.