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目的观察不同剂量丙种球蛋白治疗川崎病的临床效果。方法观察2001年1月～2005年1月在我院住院的川崎病患儿,按丙种球蛋白治疗剂量的不同随机分为三个组。A组剂量400mg/kg.日5天,B组1g/kg.单次,C组2g/kg.单次,其余治疗方法相同,均在10日内用药。观察临床症状消失时间、总热程、白细胞、C反应蛋白、血沉恢复情况、冠状动脉损害发生率,并对三组资料进行比较。结果A组临床症状消失时间明显比B、C两组长(P<0.05),差异具有显著性意义:而B、C两组之间差异无显著性意义;实验室指标B、C两组治疗后白细胞、血沉、C反应蛋白比治疗前显著下降.A组下降不明显(P<0.05),差异有显著性意义,而B、C两组指标之间变化差异无显著性意义,(P>0.05);急性期21天内,B、C两组CAL的发生率均比A组发生率低,(P<0.05),差异有显著性意义,且A组有2例发生丙种球蛋白无反应性。随访6月、18月B、C两组之间CAL发生率无显著意义.而A组有2例发生冠状动脉瘤。结论单次大剂量丙种球蛋白治疗川崎病能很快改善临床症状,降低Cal的发生率,减轻冠状动脉损害的程度。但两年内1g/kg与2g/kg相比,疗效相近。
Objective To observe the clinical effect of different dosages of gamma globulin in treating Kawasaki disease. Methods Children with Kawasaki disease hospitalized in our hospital from January 2001 to January 2005 were randomly divided into three groups according to the therapeutic dose of gamma globulin. Group A dose 400mg / kg. Day 5 days, B group 1g / kg. Single, C group 2g / kg. Single, the remaining treatment methods are the same, are within 10 days medication. Observed the disappearance of clinical symptoms, total fever, leukocytes, C-reactive protein, erythrocyte sedimentation rate, the incidence of coronary artery lesions, and the three groups of data were compared. Results The disappearance time of clinical symptom in group A was significantly longer than that in group B and C (P <0.05), and the difference was significant: there was no significant difference between group B and C; in group B and C (P <0.05), but there was no significant difference between the two groups (P> 0.05), but there was no significant difference between group B and C (P> 0.05). In the 21-day acute phase, the incidence of CAL in both groups B and C was lower than that in group A (P <0.05), and the difference was significant, and in group A, there were 2 cases of non-responsive . There was no significant difference in the incidence of CAL between the two groups at 6 months and 18 months after follow-up, while in group A, 2 cases had coronary aneurysm. Conclusion A single high-dose gamma globulin treatment of Kawasaki disease can quickly improve clinical symptoms, reduce the incidence of Cal and reduce the degree of coronary artery lesions. But within two years 1g / kg compared with 2g / kg, the effect is similar.