川崎病丙种球蛋白治疗策略与心脏损害及冠状动脉病变的相关性研究(1998-2008上海地区调查报告
천기병병충구단백치료책략여심장손해급관상동맥병변적상관성연구(1998-2008상해지구조사보고
Cardiac/coronary artery lesion in Kawasaki disease treated with different kind of intravenous immunoglobulin therapy in Shanghai from 1998-2008
  • 万方数据
    临床儿科杂志 림상인과잡지

    2009年 10期 901-905 ,共5页

    谢利剑%俞岑妍%马晓静%陈树宝%王荣发%黄美蓉%过仲珍%蒋瑾瑾%周晓迅%于清%邱定忠%桂永浩%宁寿葆%黄敏%黄国英

    사리검%유잠연%마효정%진수보%왕영발%황미용%과중진%장근근%주효신%우청%구정충%계영호%저수보%황민%황국영

    川崎病%静脉丙种球蛋白%冠脉损害 川崎病%靜脈丙種毬蛋白%冠脈損害
    천기병%정맥병충구단백%관맥손해
    Kawasaki disease%intravenous immunoglobulin%coronary artery lesion
    目的 川崎病(Kawasaki disease,KD)是一种病因未明的全身血管炎性综合征,伴冠状动脉病变(coronary artery lesion,CAL);大剂量静脉注射丙种球蛋白(intravenous immunoglobulin,IVIG)治疗KD的临床疗效肯定,但目前IVIG的用法和用量尚存在争议.该研究主要为评价不同IVIG方法治疗.KD的效果,探讨最佳治疗方案.方法 由上海市儿科心血管学组制定统一的KD调查表,发放到上海提供儿科服务的50家医院.回顾性分析1998-2008年上海地区住院KD患者的临床资料.共收集完全符合要求的KD患者资料表格1682例,其中男性1064例(63.3%),女性618例(36.7%);发病年龄(2.57±2.33)岁(0.1～18.8岁).治疗KD的IVIG方案包括1 g/ks×1次、2 g/kg×1次、0.4～0.5 g/kg×5次、1 g/kg×2次、2 g/kg×2次及其他.采用SAS 6.12统计软件包进行统计分析,计数资料采用X2检验计算;计量资料数据以X-±s表示,采用t检验.结果 在KD病程的5～10 d应用IVIG有助于最大化降低KD患者的CAL发生率;所有IVIG的KD患者中,应用方案1g/kg×2次治疗者心脏损害、冠脉病变的发生率均为最低,差异有统计学意义(P<0.05).结论 在KD病程5～10 d以IVIG 1g/kg×2次的剂量,有助于最大化降低KD患者的CAL发生率.
    목적 천기병(Kawasaki disease,KD)시일충병인미명적전신혈관염성종합정,반관상동맥병변(coronary artery lesion,CAL);대제량정맥주사병충구단백(intravenous immunoglobulin,IVIG)치료KD적림상료효긍정,단목전IVIG적용법화용량상존재쟁의.해연구주요위평개불동IVIG방법치료.KD적효과,탐토최가치료방안.방법 유상해시인과심혈관학조제정통일적KD조사표,발방도상해제공인과복무적50가의원.회고성분석1998-2008년상해지구주원KD환자적림상자료.공수집완전부합요구적KD환자자료표격1682례,기중남성1064례(63.3%),녀성618례(36.7%);발병년령(2.57±2.33)세(0.1～18.8세).치료KD적IVIG방안포괄1 g/ks×1차、2 g/kg×1차、0.4～0.5 g/kg×5차、1 g/kg×2차、2 g/kg×2차급기타.채용SAS 6.12통계연건포진행통계분석,계수자료채용X2검험계산;계량자료수거이X-±s표시,채용t검험.결과 재KD병정적5～10 d응용IVIG유조우최대화강저KD환자적CAL발생솔;소유IVIG적KD환자중,응용방안1g/kg×2차치료자심장손해、관맥병변적발생솔균위최저,차이유통계학의의(P<0.05).결론 재KD병정5～10 d이IVIG 1g/kg×2차적제량,유조우최대화강저KD환자적CAL발생솔.
    Objective To evaluate the effect of different kind of intravenous immunoglobulin (IVIG) therapy in treating Kawasaki disease (KD) and preventing cardiac consequences (coronary artery lesion, CAL). Methods A questionnaire form and guideline for KD diagnosis were sent to 50 hospitals providing pediatric medical care in Shanghai. The data from a total of 1 682 KD patients were collected. It included 1 064 males and 618 females from 1998 through 2008 in Shanghai. The average age of the KD patients was (2.57±2.33) years old (0.1-18.8 years).The patients had been divided into 6 groups for different IVIG therapy, which included 1 g/kg once, 2 g/kg once, 0.4-0.5 g/kg five times, 1 g/kg twice, 2 g/kg twice and others. SAS 6.12 software was used for statistical analysis. Results In all KD patients, the patients treated with IV1G in 5th-10th day of illness has the least cardiac complication and CAL incidence and the group with IVIG therapy of 1 g/kg twice also has the least cardiac complication and CAL incidence. Conclusions The best doses of IVIG in treating KD is 1 g/kg twice and the IVIG therapy should be used in 5th-10th day of KD illness.
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