| 摘要: |
| 目的：探讨静脉用丙种球蛋白（IVIG）无反应型川崎病（KD）的进一步治疗方法及效果。方法：将我院住院确诊为IVIG无反应型川崎病的患儿45例根据进一步治疗方案分为观察组（同时追加IVIG和糖皮质激素）38例和对照组（单纯追加糖皮质激素）7例，观察治疗效果并进行随访。结果：两组患儿体温均在24 h内恢复正常。观察组和对照组治疗前血清C反应蛋白（CRP）水平分别为（115.8±55.9）mg/L、（130.1±59.4）mg/L（P>0.05），治疗第3天分别为（22.0±8.5）mg/L、（27.7±16.3）mg/L（P>0.05），两组患儿治疗后CRP水平均降低（P均<0.05）。观察组和对照组急性期（发病0~21 d）冠状动脉损害（CAL）发生率分别为15.8%、71.4%（P<0.05），随访6个月内CAL发生率分别为5.3%、14.3%（P<0.05）。结论：同时追加IVIG和糖皮质激素进一步治疗IVIG无反应型KD与单纯追加糖皮质激素效果相当，但急性期及远期CAL发生率较低，可为临床治疗IVIG无反应型KD提供依据。 |
| 关键词: 川崎病 静脉注射丙种球蛋白 无反应型 治疗 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.12.004 |
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| 基金项目: |
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| Corticoid Combined with IVIG in the Treatment of Non-Responsiveness Kawasaki Disease |
| Guo Yihong, Yu Haiguo, Zhang Yayuan, Ma Huihui, Chen Ye, Fan Zhidan |
| (Nanjing Children’s Hospital Affiliated to Nanjing Medical University, Jiangsu Nanjiang 210008, China) |
| Abstract: |
| Objective: To investigate the clinical treatment and prognosis of intravenous immunoglobulin (IVIG) non-responsiveness Kawasaki disease (KD). Methods: 45 patients those who without response to initial treatment were assigned as non-response group, were divided into group A 38 cases (using corticoid and IVIG at the same time) and group B 7 cases (using corticoid alone), according to the different treatment strategies. Results: Mean serum concentration of C-reactive protein (CRP) was 115.8 mg/L in group A, 130.1 mg/L in group B before treatment. 22 mg/L in group A and 27.7 mg/L in group B after 3 days. It was significantly higher than those after treatment, there was no difference between group A and group B. the incidence rate of coronary artery lesions (CAL) has statistically significant differences and the prognosis is favorable in group A. the incidence rate of CAL has statistically significant differences at the time following-up 6 months. Conclusion: The temperature of all was controlled in 24 hours. The incidence of CAL was significantly different (P<0.05) in two groups in the acute phase and long-term prognosis. The results provide a strong basis for clinical treatment of intravenous immunoglobulin non- responsiveness KD. |
| Key words: Kawasaki disease Intravenous immunoglobulin Non-responsiveness Treatment |
