CAJ | 학술논문

目的：观察并对比两种大剂量静脉滴注丙种球蛋白方案治疗川崎病的效果。方法回顾性分析总结该院2005年3月—2014年3月收治的84例患小儿川崎病儿童。分成单剂给药组和连续给药组，单剂给药组直接静脉滴注蓉生静丙2 g/d，同时连续给药组静脉滴注蓉生静丙1 g，连续给药2 d，观察两组患儿急性临床症状消退时间和各项实验室指标前后变化及冠状动脉内径恢复情况，对比二者疗效。结果单剂给药组患儿发热消退时间较短于连续给药组，P<0.05，差异有统计学意义；两组患儿黏膜充血、手足肿胀和淋巴结肿大消退时间相差不大，两组比较差异无统计学意义（P>0.05）。单剂给药组患儿治疗后冠状动脉扩张均有好转迹象，单剂给药组患儿恢复例数明显多于对照组，两组比较差异有统计学意义（χ2=4.3721，P=0.0365）。两组患儿治疗前C反应蛋白、红细胞沉降率、白细胞、血小板计数均差异无统计学意义，治疗后两组患儿之间C反应蛋白和红细胞沉降率差异有统计学意义（P<0.05）；而白细胞和血小板计数差异无统计学意义（P>0.05）。结论对于治疗川崎病单次给药剂量2g/d的效果要好于1g连续给药2d的给药方式。单次给药2g/d治疗川崎病有较好的疗效，值得广泛使用于临床当中。
목적：관찰병대비량충대제량정맥적주병충구단백방안치료천기병적효과。방법회고성분석총결해원2005년3월—2014년3월수치적84례환소인천기병인동。분성단제급약조화련속급약조，단제급약조직접정맥적주용생정병2 g/d，동시련속급약조정맥적주용생정병1 g，련속급약2 d，관찰량조환인급성림상증상소퇴시간화각항실험실지표전후변화급관상동맥내경회복정황，대비이자료효。결과단제급약조환인발열소퇴시간교단우련속급약조，P<0.05，차이유통계학의의；량조환인점막충혈、수족종창화림파결종대소퇴시간상차불대，량조비교차이무통계학의의（P>0.05）。단제급약조환인치료후관상동맥확장균유호전적상，단제급약조환인회복례수명현다우대조조，량조비교차이유통계학의의（χ2=4.3721，P=0.0365）。량조환인치료전C반응단백、홍세포침강솔、백세포、혈소판계수균차이무통계학의의，치료후량조환인지간C반응단백화홍세포침강솔차이유통계학의의（P<0.05）；이백세포화혈소판계수차이무통계학의의（P>0.05）。결론대우치료천기병단차급약제량2g/d적효과요호우1g련속급약2d적급약방식。단차급약2g/d치료천기병유교호적료효，치득엄범사용우림상당중。
Objective To study and compare the effect of intravenous drip of two kinds of high-dose gamma globulin in the treat-ment of Kawasaki disease. Methods 84 cases of children suffering from Kawasaki disease admitted in our hospital from March 2005 to March 2014 were analyzed and summarized retrospectively. The patients were divided into the single-dose administration group and successive administration group. The single-dose administration group was treated by intravenous drip of Rongsheng IVIG 2g/d, the successive administration group was treated by intravenous drip of Rongsheng IVIG 1g/d for 2 days. The acute clin-ical symptoms subsiding time, the changes in various laboratory parameters and recovery of coronary artery internal diameter of the two groups were observed and the efficacy was compared between the two groups. Results The fever subsiding time of the single-dose administration group was shorter than that of the successive administration group with statistical significance, P<0.05;the dif-ferences in mucosal hyperemia, swelling of the hands and feet and lymph node subsiding time between the two groups with no sta-tistical significance (P>0.05). After treatment, the coronary artery dilatation of the children in the single-dose administration group improved, the proportion of the children with recovery in the single-dose administration group was much more than that in the successive administration group with statistical significance (χ2=4.3721,P=0.0365) . Before treatment, there were no statistically significant differences in C-reactive protein, erythrocyte sedimentation rate, white blood cell and platelet count between the two groups; after treatment, the differences in C-reactive protein and erythrocyte sedimentation rate between the groups were statisti-cally significant (P<0.05) but were not in white blood cell and platelet count (P>0.05). Conclusion For Kawasaki disease, single-dose administration of Rongsheng IVIG 2g/d has better effect than successive administration of that 1g/d for 2d. Single-dose ad-ministration of Rongsheng IVIG 2g/d is worthy of clinical wide application for it has good effect on the disease.