摘要
目的观察并比较1 g/kg×1次静脉注射丙种球蛋白(IVIG)方案与2 g/kg×1次方案分别联合阿司匹林治疗小儿川崎病(KD)的临床疗效及对冠脉病变的影响。方法入选2013年8月至2014年12月收治的85例KD患儿为研究对象,据随机数字分为A(43例)、B(42例)两组。两组均给予IVIG联合口服阿司匹林及对症支持治疗,A组使用1 g/kg×1次方案,B组使用2 g/kg×1次方案。观察并记录两组症状、体征消失时间,治疗7 d后采外周血检测红细胞沉降率(ESR)、血小板计数(PLT)、D-二聚体(D-dimmer)、超敏C-反应蛋白(hs-CRP)、N-末端脑钠肽前体(NT-pro BNP)水平,出院后3个月检查超声心动图,判定冠脉病变发生情况及程度。结果 A、B两组患儿治疗后退热时间、淋巴结肿大消退时间、结(黏)膜充血消退时间、手足肿胀消退时间差异均无统计学意义(P>0.05)。A、B两组患儿治疗7 d后ESR、PLT、D-dimmer、hs-CRP差异均无统计学意义(P>0.05)。A、B两组患儿治疗后3个月冠脉病变发生率(14.0%vs.11.9%)及损害程度构成差异均无统计学意义(χ2=0.079,P=0.778;Z=-0.272,P=0.786)。结论IVIG 1 g/kg×1次与2 g/kg×1次分别联合阿司匹林治疗KD的临床疗效及预防冠状动脉病变发生率及严重程度的作用相当,IVIG 1g/kg×1次用药方案在成本效益方面具有比较优势。
Objective To observe and compare clinical efficacy between once 1 g/kg intravenous immunoglobulin （IVIG） scheme and 2 g/kg IVIG scheme combined with oral aspirin respectively in treatment of children with kawasaki disease （KD） and influences on coronary artery lesions（ CAL）. Methods 85 KD children during August 2013 to December 2014 were enrolled as study objects and were randomized divided into Group A （43 cases） and Group B（42 cases）. Two groups were given IVIG combined with oral aspirin treatment besides support therapy group A with oncel g/kg IVIG scheme, group B with once 2 g/kg IVIG scheme, and symptoms disappearing time were observed and recorded, 7 d after treatment peripheral blood sedimentation （ ESR） , platelet count （ PLT） , D - dimmer, high sensitive C - reactive protein（ hs - CRP） and N - terminal brain natriuretic peptide （NT - proBNP） level were examined, 3 months after discharge echocardiographic examination was conducted to determine CAL occurrence and severity. Results There were no significant difference in Group A and Gr o u p B in fever fading time, lymph node enlargement fade time, andmembrane hyperaemia fading time, limbs swelling fading time （ P 〉 0 . 05）. T h e differences of ESR, P L T , D - d i m -mer ,hs - CRP, NT - proBNP after 7 d treatment between Group A and Group B have no statistical significance （ P 〉 0. 05）. Incidence on C A L （14. 0% vs. 11.9% ） and severity 3 months after discharge between Group A and Group B had no statistically significant difference （=0. 0 7 9 , P =0. 079 ; Z =0. 272 , P =0. 786）. Conclusion T h e efficiency of IVIG 1 g/kg × 1 time and 2 g /kg × 1 time combined with aspirin regimentherapy in treatment of KD and the prevention of CAL were similar,while IVIG1g/kg × 1 time regimen has a comparative advantage in terms of cost effectiveness.
出处
《临床和实验医学杂志》
2016年第18期1833-1836,共4页
Journal of Clinical and Experimental Medicine
关键词
川崎病
丙种球蛋白
冠状动脉病变
红细胞沉降率
D-二聚体
超敏C-反应蛋白
N-末端脑钠肽前体
Kawasaki disease
Immunoglobulin
Coronary artery lesions
Erythrocyte sedimentation rate
D - dimmer
High sensitive C -reactive protein
N terminal - pro brain nalriureticpeptide
