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目的对比1 g/(kg·d)大剂量静脉注射丙种球蛋白1 d和2 d两种方案对标危川崎病患儿的临床治疗效果,分析研究优选方案。方法选取2014年9月至2016年9月在本院治疗的标危川崎病的患儿共262例,分为两个组,每组131名,其中A组为1 g/(kg·d)注射丙种球蛋白1 d,B组为1 g/(kg·d)连续2 d静脉注射丙种球蛋白组,对比两组患儿的住院天数、各时间段体温及退热情况、冠状动脉是否受到损害、淋巴及粘膜症状消退情况。结果A、B两组患儿在本院治疗期间体温恢复正常、淋巴及粘膜症状消退,达到预期效果,横向对比分析两组数据,A组患儿住院天数为(13.75±3.45)d,热程天数为(2.3±0.5)d;B组患儿住院天数为(13.50±3.70)d,热程天数为(2.7±0.4)d,两组差异无统计学意义(P>0.05);纵向对比分析患儿治疗后及治疗前各项数据,C-反应蛋白、外周血白细胞计数、红细胞沉淀率、血小板计数均恢复至正常值,治疗前后差异有统计学意义(P<0.05)。结论采用单次和连续2 d静脉注射丙种球蛋白1 g/(kg·d)具同等效果,1 g/(kg·d)静脉注射丙种球蛋白1 d费用较低,为最优方案。
Objective To compare the clinical effects of high-dose 1 g / (kg · d) intravenous gamma globulin 1 d and 2 d on children with standard-risk Kawasaki disease and to analyze the optimal treatment plan. Methods A total of 262 children with Kawasaki disease who were treated in our hospital from September 2014 to September 2016 were divided into two groups (131 in each group), including 1 g / (kg · d) Gamma globulin was injected for 1 d, group B was 1 g / (kg · d) for 2 d, and gavage was administered intravenously. The days of hospitalization, body temperature and antipyretics of each group were compared, and whether the coronary artery was affected Damage, lymphatic and mucous membrane symptoms subsided. Results Both A and B children returned to normal temperature and the symptoms of lymph and mucosa subsided during the period of treatment in our hospital. The expected results were achieved. The data of two groups were compared horizontally. The hospitalization days in group A were (13.75 ± 3.45) d, (2.3 ± 0.5) d. The length of hospital stay in group B was (13.50 ± 3.70) d, and the number of days of heat treatment was (2.7 ± 0.4) d. There was no significant difference between the two groups (P> 0.05) After treatment and before treatment, the data of C-reactive protein, peripheral blood leukocyte count, erythrocyte sedimentation rate and platelet count all recovered to normal values. The difference was statistically significant before and after treatment (P <0.05). Conclusions The intravenous administration of 1 g / (kg · d) gamma globulin in single or continuous 2 d has the same effect. The lowest cost of 1 g / (kg · d) intravenous injection of gamma globulin for 1 d is the optimal solution.