摘要
目的探讨甲基泼尼松龙治疗川崎病的疗效。方法75例川崎病患儿,随机分为3组A组(33例)用静脉免疫球蛋白(IVIG)治疗,B组(22例)用甲基泼尼松龙治疗,C组(20例)联用IVIG+甲基泼尼松龙治疗。观察3组患儿用药后体温、WBC、血沉(ESR)、C反应蛋白(CRP)的变化,并动态观察左、右冠状动脉内径变化。结果①用药后,B、C组患儿在体温降至正常所需天数、ESR、CRP变化方面均少于A组,而B组同C组比较差异无显著性。②在急性期、治疗后1个月及6个月,左、右冠状动脉内径3组比较差异无显著性。③治疗后1个月,A、B和C组分别有3例、1例和2例患儿产生新的冠状动脉扩张,有6例、3例和3例患儿冠状动脉内径有缩小但仍然扩张,有17例、7例和8例扩张的冠状动脉恢复正常。3组比较,差异无显著性。治疗后6个月,3组仍然有冠状动脉扩张的患儿分别为4例、1例和2例。3组比较,差异无显著性。结论甲基泼尼松龙治疗川崎病,不仅在降温、ESR和CRP的恢复方面有效,而且能够促进扩张的冠状动脉恢复,减少冠状动脉病变的发生。
Objective To explore the therapeutic effect of Methylprednisolone on treatment of Kawasaki disease in comparison with the effects of intravenous immune globulin （IVIG） on the same disease. Methods A total of 75 children with Kawasaki disease were randomly divided into three groups and they were treated with three different therapies respectively（group A were treated with IVIG, group B were treated with Methylprednisolone, and group C were treated with Methylprednisolone plus IVIG）. The temperature, white blood cell count （WBC）, the erythrocyte sedimentation rate （ESR）, C-reactive protein, and dynamic changes of the internal diameter of coronary artery were reexamined after treatment. Results The days spent for temperature returned to normal were less in group B and group C than that in group A. ESR reduced more significantly in group B and group C than that in group A with no difference between group B and group C. The differences in the internal diameter coronary artery among these three groups were not significant in acute stage, one month and half year after treatment, respectively. Three patients in group A, one in group B, two in group C developed coronary artery dilatation one month after treatment. Six patients in group A, 3 in group B and 3 in group C had their internal diameter of coronary artery reduced, but still dilatated. Seventeen patients in group A, 7 in group B and 8 in group C had their dilatation coronary artery improved with no significant difference among these three groups. With half year after treatment, four patients in group A, one in group B and two in group C had their coronary artery dilatation with sig- nificant difference in the three groups. Conclusions Methylprednisolone could not only reduce temperature and ESR but also improve the dilatation of coronary artery and further reduce the risk of pathologic changes of coronary artery in Kawasaki disease.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2006年第6期520-522,共3页
Journal of Clinical Pediatrics
关键词
川崎病
冠状动脉扩张
甲基泼尼松龙
Kawasaki disease
coronary artery dilatation
methylprednisolone
