克拉霉素联合免疫球蛋白治疗川崎病效果观察

Effect of clarithromycin combined with intravenous immunoglobulin on reducing the recurrence rate of Kawasaki disease

目的探讨克拉霉素联合静脉免疫球蛋白对降低川崎病复发率的影响。方法选取2014年8月至2017年10月在宁波市北仑区人民医院治疗的川崎病患儿72例为研究对象。将患儿随机分配为两组,每组各36例。将接受静脉注射免疫球蛋白治疗的36例患儿设为对照组,接受静脉注射免疫球蛋白联合克拉霉素治疗的36例患儿设为观察组。观察并分析治疗前1天、治疗后第1周和第4周患儿的白细胞数、中性粒细胞、血细胞比容、天冬氨酸转氨酶、丙氨酸转氨酶、血清钠及C反应蛋白,同时对所有患儿治疗后发热持续时间、复发、反复、住院时间及Kobayashi评分进行分析。结果两组患儿在治疗后第1周和第4周的白细胞数、中性粒细胞比值、血细胞比容、天冬氨酸转氨酶、丙氨酸转氨酶、血清钠、C反应蛋白比较差异均无统计学意义(均P>0.05),两组患儿在治疗后的发热持续时间差异无统计学意义(P>0.05)。观察组的复发率(χ~2=4.126)和住院时间(t=2.635)均明显低于对照组(均P<0.05)。研究期间两组患儿均未出现病情反复情况。结论克拉霉素联合静脉免疫球蛋白治疗对降低川崎病的复发率有一定的影响。

Objective To study the effect of clarithromycin combined with intravenous immunoglobulin on reducing the recurrence rate of Kawasaki disease.Methods Seventy-two children with Kawasaki disease treated in Ningbo Beilun District People’s Hospital from August 2014 to October 2017 were selected as research objects,and they were randomly assigned to two groups with 36 cases.Children receiving intravenous immunoglobulin were in control group,and those receiving intravenous immunoglobulin combining clarithromycin were in observation group.The white blood cell count,neutrophils,hematocrit,aspartate transaminase,alanine transaminase,serum sodium and C-reactive protein were detected and analyzed at one day before treatment,1 week and 4 weeks after treatment.At the same time,the duration of fever,recurrence,relapse and hospital stay after treatment were recorded and Kobayashi score was analyzed.Results White blood cell count,neutrophil ratio,hematocrit,aspartate transaminase,alanine transaminase,serum sodium and C-reactive protein were not significantly different between two groups 1 week and 4 weeks after treatment(all P>0.05).There was no significant difference in duration of fever after treatment(P>0.05).The recurrence rate(χ~2=4.126)and the time of hospitalization(t=2.635)were significantly lower in the observation group than those in the control group(both P<0.05)There was no relapse in two groups during the study.Conclusion Clarithromycin combined with intravenous immunoglobulin has certain influence on reducing the recurrence rate of Kawasaki disease.