丙种球蛋白不同应用时间对川崎病患儿退热时间及冠状动脉损伤的影响

Effect of different application time of intravenous immune globulin on fever clearance time and coronary artery lesion of Kawasaki disease

目的：探讨丙种球蛋白不同应用时间对川崎病患儿退热时间及冠状动脉损伤的影响。方法选取2015年2月至2016年3月96例川崎病患儿，根据应用丙种球蛋白时间分三组，每组32例。早期组、中期组和晚期组分别于发病1-4 d、5-9 d、10 d 后采用丙种球蛋白治疗。对比三组临床症状消退时间、丙种球蛋白无反应及其他并发症发生情况和治疗前后三组血常规指标变化情况。结果晚期组手足肿胀消退时间短于早期组，晚期组皮疹消退时间短于早期组，早期组黏膜充血消退时间短于中期组与晚期组，早期组淋巴结缩小时间短于中期组与晚期组，差异有统计学意义（P ﹤0.05）；晚期组发热消退时间长于早期组与中期组，中期组长于早期组，晚期组冠状动脉瘤发生率、冠状动脉扩张发生率高于早期组和中期组，差异有统计学意义（P ﹤0.05）；早期组丙种球蛋白无反应发生率明显高于中期组和晚期组，差异有统计学意义（P ﹤0.05）；经治疗，三组血常规指标均较治疗前显著改善，差异有统计学意义（P ﹤0.05）。结论于发病5-9 d 采用丙种球蛋白治疗川崎病患儿疗效确切，反应性高，可缩短临床症状消退时间，降低冠状动脉损伤发生率。

Objective To investigate the application of gamma globulin in different time on tever clearance time and coronary artery lesion of patients with Kawasaki disease. Methods Ninety-six pa-tients with Kawasaki disease from February 2015 to March 2016 were selected according to the application of gamma globulin in different time,and they were divided into three groups,with 32 cases in each group. The early group,middle group and late group was given gamma globulin treatment respectively on 1-4 d,5-9 d,10 d after the onset. Clinical symptoms subsided time,gamma globulin non response and other complications occurring before and after the treatment and blood routine indexes of the three groups were compared. Results The limbs swelling subsided time in late group was less than that of the early group,the rash subsided time in late group was less than that of the early group,the mucosal hyperemia＆amp;nbsp;subsided time in early group was less than the mid and late group,the lymph node reduction time in early group was less than that of the middle group and late stage group,the differences were significant（P ﹤0. 05）. The fever subsided time in late group was longer than the that of early group and middle group, that of the middle group was longer than that of the early group. The coronary artery ectasia occurrence rate was higher in the late group than that of the early and middle group,the differences were significant （P ﹤ 0. 05）. The incidence of gamma globulin no reaction rate in early group was significantly higher than that in the middle group and late group,the differences were significant（P ﹤ 0. 05）;after treat-ment,the blood routine indexes of the three groups significantly improved,the differences were signifi-cant（P ﹤ 0. 05）. Conclusions Treating Kawasaki disease during the onset 5-9 d with immunoglobulin in children has curative effect,it can shorten the clinical symptoms subsided and reduce incidence of coronary artery lesion.