静脉注射免疫球蛋白治疗川崎病的疗效分析

THERAPEUTIC EFFECTS OF INTRAVENOUS IMMUNE GLOBULIN ON KAWASAKI DISEASE

目的 :观察免疫球蛋白 (IgG)治疗川崎病 (KD)的临床疗效 ;方法 :将 72例KD患者随机分为 3组 :A组 1 6例 ,单服阿斯匹林 (ASP) ( 3 0～ 50 )mg/ (kg·d) ,热退后减至 ( 3～5)mg/ (kg·d) ;B组 2 6例 ,静脉滴注丙种球蛋白 (IVIG) 4 0 0mg/ (kg·d)连用 5天 ;C组 3 0例 ,予丙种球蛋白 2 g/kg单剂静脉滴注。B、C两组均同时联用阿斯匹林 ,方法同A组。 3组患儿其他用药基本一致。观察其退热时间、冠状动脉病变 (CAD)发生率及其恢复时间 ;结果 :A组病例平均退热时间为 ( 4.6± 1 .4)天 ,CAD的发生率为 50 % ( 8/ 1 6 ) ,CAD平均恢复时间为 ( 1 49.7± 1 6 .5)天 ;B组病例平均退热时间为 ( 2 .0± 0 .4)天 ,CAD发生率为 2 3 .1 % ( 6 / 2 6 ) ,CAD平均恢复时间为 ( 81 .5± 2 2 .5)天 ;C组病例平均退热时间为 ( 1 .0± 1 .2 )天 ,CAD的发生率为 2 0 .0 % ( 6 / 3 0 ) ,CAD平均恢复时间为 ( 6 0 .3± 1 3 .8)天。B、C组与A组CAD发生率比较P <0 .0 5,差异有显著性 ,B组、C组相比P >0 .0 5,差异无显著性 ;CAD平均恢复时间经检验 :tAB=4.51 3 ,P <0 .0 1 ,差异有非常显著性 ;tAC=8.2 97,P <0 .0 1 ,差异有非常显著性 ,tBC=1 .796 ,P >0 .0 5,差异无显著性 ;平均退热时间经检验 :tAB=8.955,P <0 .0 1 。

Objective:To observe the therapeutic effects of intravenous immune globulin on Kawasaki disease.Methods:72 patients with Kawasaki disease were randomly divided into three groups, 16 cases in group A in which aspirin was taken (30～50)mg/(kg·d) firstly and aspirin (3～5)mg/(kg·d) secondly after abatement of fever as well as group B and C;26 cases in group B in which treatment was performed by intravenous infusions of immune globulin 400mg/(kg·d) for five days; 30 cases in group C in which immune globulin was taken by intravenous infusion (2g/kg) once.The defervescence, incidence and healing of coronary artery disease (CAD) were observed.Results:The average defervescence in Group A, B and C was 4.6±1.4 days,2.0±0.4 days and 1.0±1.2 days respectively;the incidence of CAD was 50.0%, 23.1% and 20.0% respectively;The healing time of CAD was 149.7±16.5 days, 81.5±22.5 days and 60.3±13.8 days respectively.There was a difference of incidence of CAD between group B, C and A (P<0.05) but no difference between group B and C; significant difference (P<0.01) of healing time between group B,C and A but no difference between group B and C; the average defervescence had a difference (P<0.01) between group B,C and A as group B and C.Conclusions:The defervescence, incidence of CAD and healing time of CAD could be decreased by treatment of intravenous infusion with immune globulin in patients with Kawasaki disease, specially in the treatment with immune globulin (2g/kg ).