目的观察丙种球蛋白无反应型川崎病患儿追加大剂量丙种球蛋白、应用激素治疗及两者联用的临床疗效及其对冠状动脉的影响及预后,从而为再治疗方案的选择提供依据。方法回顾性总结2010年1月至2014年2月住院确诊为丙种球蛋白无反应型川崎病患儿的临床资料,根据治疗方案的不同分为3组:Ⅰ组为追加大剂量丙种球蛋白量治疗组;Ⅱ组追加大剂量丙种球蛋白同时应用甲强龙冲击疗法,待体温稳定,口服泼尼松片;Ⅲ组直接应用甲强龙冲击疗法,待体温稳定,口服泼尼松片。同时3组口服阿司匹林片及潘生丁片。比较3组患儿症状改善情况,记录退热时间、黏膜充血消退时间、颈淋巴结肿大消退时间、手足肿胀消退时间,并统计冠状动脉病变的发生率。结果Ⅱ组的退热时间、黏膜充血消退时间、颈淋巴结肿大消退时间、手足肿胀消退时间均明显短于Ⅰ、Ⅲ组,差异有统计学意义(P<0.05),Ⅰ组与Ⅲ组症状体征改善比较差异无统计学意义(P>0.05)。随访3个月Ⅰ、Ⅱ、Ⅲ组冠状动脉病变发生率分别为31.8%、18.2%、27.8%,可见Ⅱ组冠状动脉病变发生率低于I组,I组与Ⅲ组冠状动脉病变发生率区别不大,但经统计学处理三组之间比较差异无统计学意义(P>0.05)。结论三种方案治疗无反应型川崎病均有效,激素可应用于无反应型川崎病的治疗。 Objective To observe the effect of additional large dose of gamma globulin on children with gammavonin-reactive Kawasaki disease, the clinical effects of hormone therapy and their combination with coronary artery and their prognosis, so as to provide the basis for further treatment options. Methods The clinical data of children with Kawasaki disease who did not respond to gamma globulin in our hospital from January 2010 to February 2014 were retrospectively reviewed. According to the different treatment regimens, the patients were divided into three groups: Group Ⅰ was treated with additional large doses of gamma globulin Treatment group; Group Ⅱ additional large doses of gamma globulin at the same time the application of methylprednisolone therapy, to be stable body temperature, oral prednisone tablets; group Ⅲ direct application of methylprednisolone therapy until the body temperature stable, oral prednisone tablets. At the same time three groups of oral aspirin tablets and dipyridamole tablets. Symptoms were compared between the three groups. The antipyretic time, mucosal congestive subsidence time, cervical lymph node subsidence time, hand-foot swelling and subsidence time were recorded and the incidence of coronary artery disease was recorded. Results The time of antipyretic, mucosal remission, neck subsidence and hand-foot swelling in group Ⅱ were significantly shorter than those in groups Ⅰ and Ⅲ (P <0.05). The symptoms of group Ⅰ and group Ⅲ No significant difference in signs of improvement (P> 0.05). The incidence of coronary artery lesions in group Ⅰ, Ⅱ and Ⅲ were 31.8%, 18.2% and 27.8% respectively at 3 months of follow-up. The incidence of coronary artery lesion in group Ⅱ was lower than that in group Ⅰ, and the difference between group Ⅰ and group Ⅲ Not statistically significant (P> 0.05), but there was no significant difference between the three groups after statistical treatment (P> 0.05). Conclusion The three regimens are effective in treating non-responsive Kawasaki disease. Hormone can be used in the treatment of non-responsive Kawasaki disease.