不同剂量丙种球蛋白治疗丙种球蛋白无反应型川崎病患儿的临床疗效探讨

Discussion on the Clinical Efficacy of Different Doses of Intravenous Immunoglobulin in the Treatment of Children with Intravenous Immunoglobulin-Negative Kawasaki Disease

目的探讨不同剂量丙种球蛋白(IVIG)治疗IVIG无反应型川崎病(KD)患儿的临床效果。方法将我院2018年10月至2020年10月收治的70例IVIG无反应型KD患儿随机平均分为两组。两组患儿均给予IVIG治疗,小剂量组1 g/kg,1次/d;大剂量组2 g/kg,1次/d。对比两组的治疗效果。结果大剂量组总热程、退热时间均短于小剂量组(P<0.05)。治疗前,两组的hs-CRP、TNF-α、eNOS、VEGF水平比较无统计学差异(P>0.05);治疗后,大剂量组的hs-CRP、TNF-α、eNOS、VEGF水平均优于小剂量组(P<0.05)。结论大剂量IVIG治疗IVIG无反应型KD患儿具有显著疗效,可缩短患儿退热时间,改善其炎性因子水平与血管内皮指标,进而改善预后,促进患儿尽快康复。

Objective To explore the clinical effect of different doses of intravenous immunoglobulin(IVIG)in the treatment of children with IVIG-negative Kawasaki disease(KD).Methods 70 children with IVIG-negative KD admitted to our hospital from October2018 to October 2020 were randomly divided into two groups equally.The low-dose group was treated with 1 g/kg of IVIG,once a day.The high-dose group was treated with 2 g/kg of IVIG,once a day.The treatment effects of the two groups were compared.Results The total fever course and antipyretic time of high-dose group were shorter than those of low-dose group(P<0.05).Before treatment,no statistical difference was found in the hs-CRP,TNF-α,eNOS and VEGF levels between the two groups(P>0.05).After treatment,the hs-CRP,TNF-α,eNOS and VEGF levels of the high-dose group were better than those of the low-dose group(P<0.05).Conclusions High-dose IVIG in the treatment of children with IVIG-negative KD has significant efficacy,can shorten the antipyretic time,improve the levels of inflammatory factors and vascular endothelial indidators,and then improve the prognosis,and promote the recovery of children as soon as possible.