川崎病患儿应用丙种球蛋白治疗后危险指标的随访

Follow-up After Application of Gamma IVIG in Children with Kawasaki Disease

目的:研究川崎病患儿随访过程中C反应蛋白、血红蛋白、白细胞、血小板、心肌酶、血钠、超声心动图的异同,并加以分析、比较,从而进一步指导临床治疗。方法:将入选的病例按照对丙种球蛋白(IVIG)的敏感程度分为丙球敏感组和丙球不敏感组。随访并收集研究对象的临床资料进行统计分析,总结两组患儿随访过程中的各项指标的变化。结果:两组患儿随访过程中均发现冠状动脉损伤的患儿,丙球不敏感组的发生率高于丙球敏感组;随访1个月时丙球不敏感组患儿C反应蛋白、血小板恢复速度小于丙球敏感性,两者有统计学差异(P<0.05),丙球不敏感组患儿血钠离子水平较丙球敏感组低,两者具有统计学差异(P<0.01),其余指标无统计学差异。结论:丙球不敏感组患儿C反应蛋白、血小板、血钠恢复速度较敏感组慢;两组患儿冠状动脉的发生率丙球不敏感组较丙球敏感组高,恢复期仍可出现冠脉损害,定期随访至关重要。

Objective： To analyze and compare the similarities and differences of C-reactive protein, hemoglobin, white blood cell, platelet, myocardial enzyme, serum sodium and echocardiography during the follow-up for children with Kawasaki disease, and to further guide clinical treatment. Methods：According to the sensitivity of IVIG, the patients in the selected cases were divided into two groups： sensitive group and non-sensitive group. Followed up and collected the clinical data of the subjects for statistical analysis. The results of the two groups of children during follow-up were summarized. Results： Children with coronary artery lesions were found in two groups during the follow-up, immunoglobulin insensitive group was higher than that of Ig G sensitive group; At 1 months follow-up,immunoglobulin non-sensitive group C-reactive protein, platelet recovery speed was less than the immunoglobulin sensitive group,both groups had statistically different（P〈0.05）, immunoglobulin non-sensitive group blood sodium level was lower than immunoglobulin sensitive group, both groups had statistical difference（P〈0.01）, the remaining indicators were not statistically significant. Conclusion： The recovery rate of C-reactive protein, platelet and serum sodium in the non-sensitive group was slower than that in the sensitive group. The incidence of coronary artery in the two groups was higher than that in the sensitive group, and there was still coronary damage in the recovery period. therefore,Regular follow-up is essential.