不同剂量丙种球蛋白治疗川崎病的临床效果

Clinical efficacy of different dose of gamma globulin in children with Kawasaki Disease

目的探讨不同剂量丙种球蛋白对川崎病(KD)患儿的临床效果。方法选取我院2014年2月~2015年12月的40例KD患儿作为研究对象,随机分为对照组(20例)和观察组(20例),对照组使用小剂量丙种球蛋白治疗,观察组予以大剂量丙种球蛋白。比较两组退热时间、住院时间、随访1年后冠脉病变情况及治疗前后血清C反应蛋白(CRP)、降钙素原(PCT)水平。结果观察组患儿退热时间[(21.37±2.85)h]、住院时间[(3.24±0.89)d]均短于对照组[(33.09±3.17)h、(4.98±1.15)d];随访1年后冠脉病变发生率(5.00%)低于对照组(30.00%),差异有统计学意义(P<0.05)。治疗后,两组患儿CRP、PCT水平均较治疗前有所下降,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论应用大剂量丙种球蛋白治疗KD患儿效果显著,能缩短患儿退热时间、住院时间,减少冠脉病变,有效降低其CRP及PCT水平,值得临床推广使用。

Objective To explore the clinical efficacy of different dose of gammag lobulin in children with Kawasaki disease（KD）.Methods Forty children with KD from February 2014 to December 2015 were selected and randomly divided into the control group and the observation group,with 20 cases in each group.The control group was treated with lowdose gamma globulin,while the observation group was treated with high dose gammag lobulin.The time of fever clearance and hospitalization,the incidence of coronary artery lesions,and the levels of C-reactionprotein（CRP） and procalcitonin（PCT） before and after treatment of children in two groups were compared.Results The time of fever clearance and hospitalization of children in the observation group [（21.37±2.85）h,（3.24±0.89）d] were shorter than those in the control group[（33.09±3.17） h,（4.98±1.15）d],the differences were statistically significant（P〈0.05）;the incidence of coronary artery lesions after 1 year follow-up in the observation group（5.00%） was lower than that in the control group（30.00%）,the difference was statistically significant（P〈0.05）.After treatment,the levels of CPR and PCT of children in two groups were decreased,comnpared with those before treatment,and those in the observation group were lower than those in the control group,and the differences were statistically significant（P〈0.05）.Conclusion The application of high dose of gamma globulin has significant effect in children with KD,which can shorten the time of fever clearance and hospitalization,reduce coronary artery lesions and decrease the levels of CRP and PCT of children.It is worthy of clinical application.