国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2013年
23期
3607-3610
,共4页
川崎病%C反应蛋白%静脉丙种球蛋白%儿童
川崎病%C反應蛋白%靜脈丙種毬蛋白%兒童
천기병%C반응단백%정맥병충구단백%인동
Kawasaki disease%C reactive protein%Intravenous immunoglobulin%Children
目的 分析川崎病患儿血清C反应蛋白(CRP)在静脉丙种球蛋白(IVIG)治疗过程中的变化,对血清CRP变化水平预测IVIG治疗不敏感患儿的疗效进行评价.方法 收集2009年1月至2012年12月在我院与广东省妇幼保健院住院的川崎病患儿;首剂IVIG(2g· kg-1·d-1)治疗后48 h退热为A组,未退热者再予相同剂量IVIG,次剂48 h退热为B组,继续/反复发热为C组.所有患儿均在首剂IVIG前、首剂48 h后(次剂IVIG前)抽取CRP.分析各组CRP变化情况及其与冠状动脉病变(CALs)的关系.结果 纳入病例146例,男性患儿84例,女性患儿62例,A组110例,B组26例,C组10例.发生CALs 20例,A、B、C组分别有8(7.3％)、5(19.2％)、7(70.0％)例.CALs阳性与阴性患儿首剂IVIG前CRP的差异无统计学意义(P＞0.05),治疗48 h后差异具有统计学意义(P＜0.05).A、B、C三组比较,首剂IVIG治疗前组间CRP水平、最终形成CALs的例数差异无统计学意义(P＞0.05),48 h后差异有统计学意义(P＜0.05),结果表明CRP水平的变化与CALs的发生有相关性.结论 对首剂IVIG不敏感的患儿更易患CALs,治疗48 h后CRP水平仍然较高者更易发生CALs;对首剂IVIG不敏感者在首剂IVIG治疗后48 h CRP仍然较高时,很可能对次剂IVIG仍然失败,应及早考虑对此类表现的患儿使用更强的抗炎手段.
目的 分析川崎病患兒血清C反應蛋白(CRP)在靜脈丙種毬蛋白(IVIG)治療過程中的變化,對血清CRP變化水平預測IVIG治療不敏感患兒的療效進行評價.方法 收集2009年1月至2012年12月在我院與廣東省婦幼保健院住院的川崎病患兒;首劑IVIG(2g· kg-1·d-1)治療後48 h退熱為A組,未退熱者再予相同劑量IVIG,次劑48 h退熱為B組,繼續/反複髮熱為C組.所有患兒均在首劑IVIG前、首劑48 h後(次劑IVIG前)抽取CRP.分析各組CRP變化情況及其與冠狀動脈病變(CALs)的關繫.結果 納入病例146例,男性患兒84例,女性患兒62例,A組110例,B組26例,C組10例.髮生CALs 20例,A、B、C組分彆有8(7.3％)、5(19.2％)、7(70.0％)例.CALs暘性與陰性患兒首劑IVIG前CRP的差異無統計學意義(P＞0.05),治療48 h後差異具有統計學意義(P＜0.05).A、B、C三組比較,首劑IVIG治療前組間CRP水平、最終形成CALs的例數差異無統計學意義(P＞0.05),48 h後差異有統計學意義(P＜0.05),結果錶明CRP水平的變化與CALs的髮生有相關性.結論 對首劑IVIG不敏感的患兒更易患CALs,治療48 h後CRP水平仍然較高者更易髮生CALs;對首劑IVIG不敏感者在首劑IVIG治療後48 h CRP仍然較高時,很可能對次劑IVIG仍然失敗,應及早攷慮對此類錶現的患兒使用更彊的抗炎手段.
목적 분석천기병환인혈청C반응단백(CRP)재정맥병충구단백(IVIG)치료과정중적변화,대혈청CRP변화수평예측IVIG치료불민감환인적료효진행평개.방법 수집2009년1월지2012년12월재아원여광동성부유보건원주원적천기병환인;수제IVIG(2g· kg-1·d-1)치료후48 h퇴열위A조,미퇴열자재여상동제량IVIG,차제48 h퇴열위B조,계속/반복발열위C조.소유환인균재수제IVIG전、수제48 h후(차제IVIG전)추취CRP.분석각조CRP변화정황급기여관상동맥병변(CALs)적관계.결과 납입병례146례,남성환인84례,녀성환인62례,A조110례,B조26례,C조10례.발생CALs 20례,A、B、C조분별유8(7.3％)、5(19.2％)、7(70.0％)례.CALs양성여음성환인수제IVIG전CRP적차이무통계학의의(P＞0.05),치료48 h후차이구유통계학의의(P＜0.05).A、B、C삼조비교,수제IVIG치료전조간CRP수평、최종형성CALs적례수차이무통계학의의(P＞0.05),48 h후차이유통계학의의(P＜0.05),결과표명CRP수평적변화여CALs적발생유상관성.결론 대수제IVIG불민감적환인경역환CALs,치료48 h후CRP수평잉연교고자경역발생CALs;대수제IVIG불민감자재수제IVIG치료후48 h CRP잉연교고시,흔가능대차제IVIG잉연실패,응급조고필대차류표현적환인사용경강적항염수단.
Objective To analyze the serum C reactive protein (CRP) level in children with Kawasaki disease (KD) during the treatment with intravenous immunoglobulin (IVIG).Methods The study objects were collected from January 2009 to December 2012 in the two women and children hospitals.All the patients received IVIG of 2 g/kg daily.The children afebrile in 48 hours after initial administration of IVIG were defined as group A.The febrile children were given second IVIG.Patients who were afebrile in 48 hours after second IVIG were defined as group B.The rest was assigned to group C.CRP levels were detected before initial IVIG and 48 hours after initial IVIG in all the children.Then the data were analyzed statistically.Results 146 children were enrolled and 84 were male and 62 were female.Group A had 110 children with 8 developing CALs (7.3％),group B had 26 children with 5 CALs (19.2％),group C had 10 with 7 CALs (70％).There was significant difference in CRP level 48 hours after initial IVIG between the CALs and the negative children but no difference before initial IVIG.There were no significant differences in both CRP level and CALs between each group pairs before initial IVIG.48 hours after administration of initial IVIG,there were significant differences in both CRP level and CALs among groups A,B,and C.It showed that there was correlation between CRP level and the development of CALs.Conclusions Patients unresponsive to IVIG are liable to develop CALs.Patients with high CRP level 48 hours after initial IVIG are liable to develop to CALs as well.The patients who are the non-responder with high CRP are likely to fail in the additional IVIG treatment.These patients may need other powerful anti-inflammation therapy earlier.
