丙种球蛋白应用时间对川崎病患儿退热时间及冠状动脉损伤的影响价值

Effect of Gamma Globulin Application Time on Antipyretic Time and Coronary Artery Injury in Children with Kawasaki Disease

目的:探讨丙种球蛋白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:选择笔者所在医院2015年5月-2018年2月收治的70例川崎病患儿。将其随机分为对照组和观察组,每组35例。对照组采取发病后大于10 d使用丙种球蛋白治疗,观察组则采取发病后5~10 d使用丙种球蛋白治疗。比较两组临床疗效,退热时间、手足肿胀、颈部淋巴结肿大、皮疹及黏膜充血消退时间,治疗前后患儿血小板计数、C反应蛋白和红细胞沉降率,冠状动脉损伤发生率。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。观察组退热时间、手足肿胀、颈部淋巴结肿大、皮疹及黏膜充血消退时间均短于对照组,差异有统计学意义(P<0.05)。观察组血小板计数、C反应蛋白和红细胞沉降率均优于对照组,差异有统计学意义(P<0.05)。观察组冠状动脉损伤发生率低于对照组,差异有统计学意义(P<0.05)。结论:发病后5~10 d使用丙种球蛋白治疗川崎病可获得较好预后。

Objective:To investigate the effect of Gamma Globulin application time on antipyretic time and coronary artery injury in children with Kawasaki disease.Method:70 cases of Kawasaki disease admitted in our hospital from May 2015 to February 2018 were selected.They were randomly divided into control group and observation group,35 cases in each group.The control group was treated with Gamma Globulin more than 10 d after onset,while the observation group was treated with Gamma Globulin 5-10 d after onset.The clinical efficacy,antipyretic time,hand and foot swelling,enlargement of cervical lymph nodes,rash and regression time of mucosal congestion,platelet count,C-reactive protein and erythrocyte sedimentation rate before and after treatment,and the incidence of coronary artery injury were compared between the two groups.Result:The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).The antipyretic time,hand and foot swelling,enlargement of cervical lymph nodes,rash and regression time of mucosal congestion of the observation group were shorter than those of the control group,the differences were statistically significant(P<0.05).The platelet count,C-reactive protein and erythrocyte sedimentation rate in the observation group were better than those in the control group,the differences were statistically significant(P<0.05).The incidence of coronary artery injury in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:The treatment of kawasaki disease with Gamma Globulin 5-10 d after onset can obtain better prognosis.