文章摘要

静脉注射免疫丙种球蛋白的不同用药时机对川崎病患儿疗效及其并发症的影响

作者: 1张喜芳
1 安阳市第五人民医院儿科,河南 安阳 455000
通讯: 张喜芳 Email: 2295718962@qq.com
DOI: 10.3978/j.issn.2095-6959.2018.05.013

摘要

目的:分析静脉注射免疫丙种球蛋白(intravenous immunoglobulin,IVIG)的用药时机对川崎病患儿疗效及冠状动脉并发症发生率的影响。方法:选择2011年1月至2017年6月河南安阳市第五人民医院收治的52例川崎病患儿。按照IVIG用药时机的不同分成2组:早期组19例(发病7 d内确诊治疗)、晚期组33例(发病7 d以上确诊治疗)。观察两组临床疗效和冠状动脉并发症发生率。结果:早期组发热消退时间、淋巴结肿大时间、黏膜充血时间和皮疹持续时间分别为(5.75±0.52),(6.51±0.68),(4.60±0.21)和(5.62±0.32) d;晚期组发热时间、淋巴结肿大时间、黏膜充血时间和皮疹持续时间分别为(10.21±0.66),(8.65±0.64),(8.95±0.38)和(8.14±0.68) d。与晚期组相比,早期组发热消退时间、黏膜充血时间和皮疹持续时间均较快,差异有统计学意义(P<0.05)。早期组患儿冠状动脉扩张率为5.26%,低于晚期组的18.18%,差异有统计学意义(P<0.05)。早期组患儿治疗后的WBC,PLT,CRP,ESR指标均优于晚期组,差异有统计学意义(P<0.05)。治疗前,两组AST、肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isozyme,CK-MB)等指标对比差异无统计学意义(P>0.05);治疗后,两组上述指标均明显降低,且早期组的显著低于晚期组(P<0.05)。结论:早期使用丙种球蛋白治疗川崎病药能够降低冠状动脉并发症发生率,改善患者症状及血液指标。
关键词: 川崎病;静脉注射免疫丙种球蛋白;用药时机;冠状动脉并发症

Effect of different timing of medication of intravenous immunoglobulin on therapeutic effects and complications of intravenous on children with Kawasaki disease

Authors: 1ZHANG Xifang
1 Department of Pediatrics, Fifth People’s Hospitalof An’yang, An’yang Henan 455000, China

CorrespondingAuthor: ZHANG Xifang Email: 2295718962@qq.com

DOI: 10.3978/j.issn.2095-6959.2018.05.013

Abstract

Objective: To investigate the influence of intravenous immunoglobulin (IVIG) timing of medication on children with Kawasaki disease. Methods: A total of 52 cases of Kawasaki disease were selected in our hospital during the period from January 2011 to June 2017. According to the IVIG timing of medication, all the cases were divided into early treatment group (diagnosed within 7 days) and late treatment group (more than 7 days of diagnosis and treatment); 19 cases in early treatment group and 33 cases in the late treatment group. The therapeutic effects and complications were collected and compared. Results: Heat fading time, lymph node enlargement time, mucosal hyperemia time and rash duration time were (5.75±0.52), (6.51±0.68), (4.60±0.21) and (5.62±0.32) d in early treatment group respectively, (10.21±0.66), (8.65±0.64), (8.95±0.38) and (8.14±0.68) d in late treatment group, respectively, and there are significant difference in the these indexes (P<0.05). The rate of coronary dilatation in the early treatment group was 5.26%, which was lower than that of the late treatment group (18.18%), and the difference was statistically significant (P<0.05). The results showed that the indexes of WBC, PLT, CRP and ESR in the early treatment group were better than those in the late treatment group (P<0.05). Before treatment, there was no significant difference in aspartate aminotransferase (AST), creatine kinase (CK) and creatine kinase isozyme (CK-MB) between the two groups (P>0.05). After treatment, the above indexes of the two groups were obviously reduced, and the indexes of early treatment group were significantly lower than late treatment group (P<0.05). Conclusion: The early treatment Kawasaki disease with IVIG can reduce coronary complications and improve the symptoms and blood index.
Keywords: Kawasaki disease; intravenous immunoglobulin; timing of medication; coronary complications

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