大剂量丙种球蛋白静脉输注治疗川崎病患儿的疗效观察

Clinical Observation of High-dose Gamma Globulin Intravenous Infusion on Children in Patients with Kawasaki Disease

目的探讨大剂量丙种球蛋白静脉输注对川崎病患儿临床症状及实验室指标的影响。方法选取2012年4月-2014年12月在湖北某医院就诊的78例川崎病患儿为研究对象,根据入院顺序随机分为观察组和对照组,观察组患儿40例,接受大剂量丙种球蛋白静脉输注治疗,对照组患儿38例,接受常规剂量丙种球蛋白静脉输注治疗。比较2组患儿的临床症状持续时间、住院时间以及实验室相关指标。结果观察组患儿发热、淋巴结肿大、黏膜充血、手足硬肿的持续时间分别为(1.75±0.54)d,(2.02±0.25)d,(1.82±0.25)d,(1.02±0.21)d,短于对照组的(3.06±0.63)d,(2.56±0.35)d,(2.41±0.30)d,(1.53±0.28)d,差异均有统计学意义(P<0.05)。治疗后,观察组患儿住院总时间为(7.51±0.86)d,短于对照组的(10.34±1.26)d,差异有统计学意义(P<0.05);观察组患儿体内N-末端脑钠肽前体(NT-proBNP)、脑钠肽(BNP)、血清降钙素原(PCT)、C反应蛋白(CRP)水平明显低于对照组,差异有统计学意义(P<0.05);免疫球蛋白IgA,IgG水平明显高于对照组,差异有统计学意义(P<0.05)。结论大剂量丙种球蛋白静脉输注有助于迅速缓解川崎病患儿的临床症状,减轻炎症反应,减少心肌损伤,提高其机体免疫功能。

Objective To study the curative effect of high-dose gamma globulin intravenous infusion on children in patients with Kawasaki disease. Methods 78 children with Kawasaki disease from Apr. 2012 to Dec. 2014 in one of Xiantao hospitals were selected and randomly divided into observation group and control group. The ob- servation group （40 cases） received high-dose intravenous gamma globulin treatment, and the control group （38 cases） received conventional-dose intravenous gamma globulin treatment. Then symptoms disappearing time, hospital stays and laboratory indexes were compared between two groups. Results Clinical symptoms of fever, swollen lymph nodes, mucosal congestion and foot hard swelling of observation group lasted for（1.75± 0.54） d,（2.02±0.25） d,（1.82±0.25） d and （1.02±0.21）d respectively, which was shorter than the time of control group （（3.06±0.63） d,（2.56±0.35） d,（2.41±0.30） d,（1.53±0.28） d） （P〈0.05）. Hospital stays of observation group （7.51±0.86）d was shorter than that of control group （10.34±1.26）d after treatment （P〈 0.05）. Indexes of NT-proBNP, BNP, PCT and CRP of observation group were significantly lower than those of control group （P〈0.05）. Indexes of IgA and IgG of observation group were higher than those of control group after treatment（P〈0.05）. Conclusion The high-dose intravenous gamma globulin helps relieve clinical symptoms quickly, relieve inflammation, ease myocardial injury, and improve body＇s immune function.