CAJ | 학술논문

目的：观察分析川崎病超早期使用静注丙种球蛋白的疗效。方法选择2008年1月至2012年12月收住嵊州市人民医院的52例川崎病患儿，按使用丙球的不同时间分为A组和B组，A组20例，在发热5天内联合使用静注丙球2g/kg和阿司匹林30～50mg/kg治疗，B组32例，在发热第6～9天内联合使用静注丙球2g/kg和阿司匹林30～50mg/kg治疗，观察两组使用丙球后持续发热时间、总发热时间、冠状动脉病变发生率及使用丙球次数。结果 B组使用丙种球蛋白持续发热时间为（1．03±1．56）d，与A组的（3．04±1．52）d相比有显著性差异（t＝4．83，P＜0．05）。 B组使用丙球次数为（1．23±0．66）次，与A组的（2．07±0．51）次相比（t＝5．09，P＜0．05）。 B组追加使用丙球为9．38％（3/38），低于A组的50．00％（10/20）（χ2＝4．27，P＜0．05）。两组总发热时间和淋巴结肿大消退时间比较，差异无统计学意义（t值分别为1．07和2．35，P＞0．05）。两组患者2周、1个月、6个月后冠脉病变发生率比较，差异无统计学意义（χ2值分别为1．30、2．11、1．18，均P＞0．05）。结论两组使用静注丙种球蛋白治疗川崎病均有一定效果，以第6～9天效果较好，且成本较低。
목적：관찰분석천기병초조기사용정주병충구단백적료효。방법선택2008년1월지2012년12월수주승주시인민의원적52례천기병환인，안사용병구적불동시간분위A조화B조，A조20례，재발열5천내연합사용정주병구2g/kg화아사필림30～50mg/kg치료，B조32례，재발열제6～9천내연합사용정주병구2g/kg화아사필림30～50mg/kg치료，관찰량조사용병구후지속발열시간、총발열시간、관상동맥병변발생솔급사용병구차수。결과 B조사용병충구단백지속발열시간위（1．03±1．56）d，여A조적（3．04±1．52）d상비유현저성차이（t＝4．83，P＜0．05）。 B조사용병구차수위（1．23±0．66）차，여A조적（2．07±0．51）차상비（t＝5．09，P＜0．05）。 B조추가사용병구위9．38％（3/38），저우A조적50．00％（10/20）（χ2＝4．27，P＜0．05）。량조총발열시간화림파결종대소퇴시간비교，차이무통계학의의（t치분별위1．07화2．35，P＞0．05）。량조환자2주、1개월、6개월후관맥병변발생솔비교，차이무통계학의의（χ2치분별위1．30、2．11、1．18，균P＞0．05）。결론량조사용정주병충구단백치료천기병균유일정효과，이제6～9천효과교호，차성본교저。
Objective To observe and analyze the effect of intravenous gamma globulin on Kawasaki disease in ultra -early period . Methods From January 2008 to December 2012 52 children were diagnosed with Kawasaki disease in Shengzhou People ’s Hospital.They were divided into group A and group B according to different time of using gamma globulin .There were 20 cases in group A, treated by 2g/kg intravenous gammaglobulin combined with aspirin (30-50mg/kg) within 5 days after the onset of fever .In group B there were 32 cases, treated by 2g/kg intravenous gammaglobulin combined with aspirin (30-50mg/kg) in the course of fever within 6-9 days.Fever time, total heating time, incidence of coronary artery disease and the number of times of using gammaglobulin were observed in two groups . Results The fever time of group B was 1.03 ±1.56 d, which was significantly different from that of group A (3.04 ±1.52d) ( t=4.83, P<0.05).The number of times of using gammaglobulin in group B was 1.23 ±0.66, and that was 2.07 ±0.51 in group A (t=5.09, P<0.05).The additional using rate in group B was 9.38% (3/38), which was significantly less than group A (50%, 10/20) (χ2 =4.27,P<0.05).There were no significant differences in total heating time and regression time of lymphadenectasis between two groups (t value was 1.07 and 2.35, respectively, both P<0.05).The incidence of coronary artery disease in two groups after 2 weeks, 1 month and 6 months was not significantly different between two groups (χ2 value was 1.30, 2.11 and 1.18, respectively, allP >0.05). Conclusion Using intravenous immunoglobulin in treatment of Kawasaki disease in two groups has certain effect .The cost is low and it is better within 6-9 days.