| 摘要: |
| 目的:探讨小剂量甲基泼尼松联合静脉丙种球蛋白(IVIG)治疗IVIG无反应型川崎病(KD)患儿的临床疗效。方法:将32例IVIG无反应型KD患儿随机分为治疗组和对照组各16例,对照组在常规治疗基础上静脉滴注IVIG 2.0 g/ kg治疗1次;治
疗组在对照组基础上加用甲基泼尼松2 mg/ (kg·d)治疗3 d。比较两组患儿治疗前后的临床症状、白细胞(WBC)计数、血沉(ESR)和超敏C反应蛋白(hsCRP)水平;比较两组患儿治疗后血小板(PLT)计数、D-二聚体(D-dimer) 水平、纤维蛋白原(FIB)水平和不良反应;随访1年,比较两组发生冠状动脉扩张(CAL)情况。结果:治疗后,治疗组临床症状恢复时间均短于对照组(P<0.05);两组在入院时和初次治疗后36 h WBC计数、ESR和hsCRP水平比较差异均无统计学意义(P>0.05);治疗后72 h治疗组WBC计数、ESR和hsCRP水平均低于对照组(P<0.05);两组治疗后PLT、D-dimer水平和FIB水平比较差异无统计学意义(P>0.05);随访1年,治疗组发生CAL例数低于对照组(P<0.05)。结论:小剂量甲基泼尼松联合静脉滴注IVIG治疗IVIG无反应型KD患儿可以明显改善患儿临床症状,迅速改善急性期炎性反应指标,快速控制血管炎症,有效减少冠状动脉病变的发生。 |
| 关键词: 川崎病 甲基泼尼松 无反应型 静脉丙种球蛋白 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.08.006 |
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| 基金项目: |
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| Therapeutic Effect of Methylprednisolone on IVIG Non-Responsiveness Kawasaki Disease |
| Chen Ying, Zeng Rong |
| (The First People's Hospital in Yibin, Sichuan Yibin 664000, China) |
| Abstract: |
| Objective: To explore the clinical efficacy of the small doses of methylprednisolone combined with intravenous gamma globulin (IVIG) for the treatment of IVIG non-responsiveness Kawasaki disease (KD) in children. Methods: Thirty two cases of IVIG children without reaction type KD were randomly divided into treatment group and control group with 16 cases in each group. The control group on the basis of conventional therapy was given intravenous infusion of IVIG 2.0 g/kg one time, the observation group on the basis of control group was given methylprednisolone 2 mg/ (kg·d) for 3 days. The clinical symptoms, blood routine (WBC), blood sedimentation (ESR) and hypersensitive C-reactive protein (hsCRP) of two groups before and after the treatment were compared. The platelet (PLT) count, D-dimer, fibrinogen (FIB) and adverse reaction of two groups before and after the treatment were compared. Results: After the treatment, the clinical symptom recovery time of treatment group was shorter than the control group (P<0.05). The WBC, ESR and hsCRP of two groups between admission and were not statistically significant after 36 hours (P>0.05). The WBC, ESR and hsCRP of treatment group were lower than the control group after 72 hours (P<0.05). The PLT, D-dimer and FIB of two groups were not statistically significant after the treatment (P>0.05). The incidence of CAL in treatment group was lower than the control group after 1 year’s follow-up. Conclusion: Small dose methylprednisolone combined with intravenous infusion of IVIG in children with IVIG non-responsiveness KD can significantly improve the clinical symptoms, recover acute phase inflammatory reaction index, control the vascular inflammation rapidly, and reduce the occurrence of coronary artery lesions. |
| Key words: Kawasaki disease methylprednisolone non-responsiveness intravenous gamma globulin |
