阿司匹林联合大剂量丙种球蛋白治疗小儿川崎病的效果及对血清脑利钠肽的影响

Aspirin combined with a high dose of gamma globulin in treatment of children with Kawasaki disease and its effect on serum brain natriuretic peptide

目的探讨阿司匹林联合大剂量丙种球蛋白治疗小儿川崎病的效果及对血清脑利钠肽(BNP)的影响。方法本次研究对象为本院2013年1月至2018年1月收治的80例川崎病患儿,随机将其分成对照组和观察组,各40例。两组均使用同等剂量的阿司匹林治疗,对照组加用常规剂量[400mg/(kg·d)]丙种球蛋白,观察组加用大剂量[2g/(kg·d)]丙种球蛋白,比较两组临床效果及对BNP水平的影响。结果观察组发热、颈部淋巴结肿大、口腔黏膜充血、手足硬肿症状消失时间分别为(1.20±0.51)d、(1.11±0.40)d、(1.10±0.34)d、(1.21±0.21)d,均短于对照组的(2.41±0.75)d、(2.20±0.86)d、(2.01±0.64)d、(2.42±0.86)d。治疗前,两组BNP水平差异无统计学意义;治疗后,观察组BNP(228.61±33.54)pg/ml,对照组(410.35±48.41)pg/ml,差异有统计学意义(P<0.05)。结论阿司匹林联合大剂量丙种球蛋白治疗小儿川崎病能快速改善患者的临床症状,降低BNP水平,值得临床进一步推广。

Objective To investigate the effect of aspirin combined with a high dose of gamma globulin in the treatment of children with Kawasaki disease and its effect on serum brain natriuretic peptide (BNP). Methods 80 children with Kawasaki disease treated at our hospital from January, 2013 to January, 2018 were selected and randomly divided into a control group and an observation group, 40 cases for each group. Both groups were treated with the same dose of aspirin. The control group was treated with gamma globulin, 400 mg/(kg?d);and the observation group, 2 g/(kg?d). The clinical effect and the effect on BNP level of the two groups were compared. Results The times for the disappearance of fever, cervical lymph node enlargement, oral mucous congestion and hand and foot scleredema were (1.20 ±0.51) d,(1.11 ±0.40) d,(1.10 ±0.34) d and (1.21 ±0.21) d in the observation group, and were (2.41 ±0.75) d,(2.20 ±0.86) d,(2.01 ±0.64) d, and (2.42 ±0.86) d in the control group. There was no statistical difference in BNP level between the two groups before the treatment. After the treatment, the BNP level was (228.61 ±33.54) pg/ml in the observation group, and was (410.35 ±48.41) pg/ml in the control group, with a statistical difference (P < 0.05). Conclusion Aspirin combined with a high dose of gamma globulin in the treatment of children with Kawasaki disease can quickly improve the clinical symptoms and reduce the level of BNP, which is worthy of further clinical promotion.