川崎病并发冠状动脉病变的早期防治

Early prevention and treatment of Kawasaki disease complicated by coronary artery disease

目的 探讨川崎病（KD）并发冠状动脉病变患者的早期防治方法与效果。方法 将我院2004年1月~2014年7月接诊的川崎病并发冠状动脉病变患者42例作为研究对象,随机均分为研究组与对照组,各自21例。其中对照组患者早期单用阿司匹林防治,而研究组患者则采取静注丙种球蛋白并予以阿司匹林治疗。观察记录两组患者心脏彩超与实验室检查结果,并对比分析。结果 经心脏彩超检查治疗前后可知,研究组治疗前彩超正常患儿治疗后转为异常有1例,而对照组则出现5例,组间对比差异有统计学意义（P〈0.05）;两组患者治疗前实验室指标无显著性差异,但治疗后研究组在实验室指标上皆明显低于对照组,更趋于正常范围,组间对比差异有统计学意义（P〈0.05）。结论 静脉滴注丙种球蛋白用于早期防治川崎病并发冠状动脉病变患者可取得比较良好的效果,防治效果显著,同时能明显改善患者的实验室指标,值得借鉴。

Objective To investigate the method and efficacy of early prevention and treatment in patients with Kawasaki disease （KD） complicated by coronary artery disease （CAD）. Methods Forty-two patients with KD complicated by CAD who visited our hospital from January 2004 to July 2014 were randomly divided into study group （n=21） and control group （n=21）. The control group used aspirin alone for prevention and treatment in the early stage, while the study group was given gamma globulin by intravenous drip. Echocardiographic findings and laboratory examination results were compared between the two groups. Results The echocardiography showed that one case in the study group who had normal echocardiographic findings showed abnormal echocardiographic findings after treatment, versus 5 cases in the control group （P〈0.05）. There were no significant differences in laboratory markers between the two groups before treatment, but the treatment group had significantly lower laboratory markers （closer to normal values） than the control group after treatment （P〈0.05）. Conclusion An intravenous drip of gamma globulin has good efficacy in the early prevention and treatment of KD complicated by CAD and can improve patientsI laboratory markers, so this therapy holds promise for clinical application.