实用医学杂志
實用醫學雜誌
실용의학잡지
The Journal of Practical Medicine
2015年
16期
2651-2654
,共4页
川崎病%免疫丙种球蛋白%无反应
川崎病%免疫丙種毬蛋白%無反應
천기병%면역병충구단백%무반응
Kawasaki disease%Intravenous immunoglobulin%Nonresponse
目的:研究大剂量静脉注射丙种球蛋白(IVIG)治疗川崎病无反应的影响因素. 方法:回顾分析2008年7月至2013年12月期间163例住院川崎病患儿的临床资料, 根据首次对IVIG的治疗效果将患儿分为IVIG敏感型和IVIG无反应型,对比两型川崎病患儿的临床特点及实验室检查指标.结果:两组患儿在发病年龄、性别、IVIG 治疗前发热时间、临床表现完全与否及血 WBC、CK-MB、PLT、ESR 方面差异无显著性(P > 0.05). 无反应型组无菌性脓尿、颈部淋巴结肿大、冠状动脉损害发生率及外周血中性粒细胞比例、CRP、AST、ALT、总胆红素显著高于敏感型组(P < 0.001),而血白蛋白、高密度脂蛋白、钠离子浓度则低于IVIG敏感型患儿(P < 0.05). 结论:无菌性脓尿、冠状动脉损害、颈部淋巴结肿大发生率及外周血中性粒细胞比例增高;血CRP、AST、ALT、总胆红素浓度增高;血浆白蛋白和钠离子浓度减少是川崎病患儿 IVIG无反应的危险因素.
目的:研究大劑量靜脈註射丙種毬蛋白(IVIG)治療川崎病無反應的影響因素. 方法:迴顧分析2008年7月至2013年12月期間163例住院川崎病患兒的臨床資料, 根據首次對IVIG的治療效果將患兒分為IVIG敏感型和IVIG無反應型,對比兩型川崎病患兒的臨床特點及實驗室檢查指標.結果:兩組患兒在髮病年齡、性彆、IVIG 治療前髮熱時間、臨床錶現完全與否及血 WBC、CK-MB、PLT、ESR 方麵差異無顯著性(P > 0.05). 無反應型組無菌性膿尿、頸部淋巴結腫大、冠狀動脈損害髮生率及外週血中性粒細胞比例、CRP、AST、ALT、總膽紅素顯著高于敏感型組(P < 0.001),而血白蛋白、高密度脂蛋白、鈉離子濃度則低于IVIG敏感型患兒(P < 0.05). 結論:無菌性膿尿、冠狀動脈損害、頸部淋巴結腫大髮生率及外週血中性粒細胞比例增高;血CRP、AST、ALT、總膽紅素濃度增高;血漿白蛋白和鈉離子濃度減少是川崎病患兒 IVIG無反應的危險因素.
목적:연구대제량정맥주사병충구단백(IVIG)치료천기병무반응적영향인소. 방법:회고분석2008년7월지2013년12월기간163례주원천기병환인적림상자료, 근거수차대IVIG적치료효과장환인분위IVIG민감형화IVIG무반응형,대비량형천기병환인적림상특점급실험실검사지표.결과:량조환인재발병년령、성별、IVIG 치료전발열시간、림상표현완전여부급혈 WBC、CK-MB、PLT、ESR 방면차이무현저성(P > 0.05). 무반응형조무균성농뇨、경부림파결종대、관상동맥손해발생솔급외주혈중성립세포비례、CRP、AST、ALT、총담홍소현저고우민감형조(P < 0.001),이혈백단백、고밀도지단백、납리자농도칙저우IVIG민감형환인(P < 0.05). 결론:무균성농뇨、관상동맥손해、경부림파결종대발생솔급외주혈중성립세포비례증고;혈CRP、AST、ALT、총담홍소농도증고;혈장백단백화납리자농도감소시천기병환인 IVIG무반응적위험인소.
Objective To investigate the clinical features of nonresponsive Kawasaki disease by intravenous immunoglobulin. Methods The clinical data of 163 hospitalized patients of Kawasaki disease from June 2008 to February 2013 were analyzed retrospectively based on the response to high intravenous immunoglobulin (IVIG) therapy. All patients were divided into responsive group and nonresponsive group. The clinical characteristics and biochemical index were compared in two groups. Results The nonresponsive group had more frequently experienced in coronary artery lesion, cervical lymph node enlargement, sterile pyuria and higher levels of neutrophils, CRP, AST, ALT, TBIL and lower levels of albumin, high density lipoprotein, serum sodium concentration than the responsive group (P < 0.05). No differences was found in the age, sex, duration of fever at initial treatment, clinical manifestations complete or incomplete and WBC, CK-MB, PLT, ESR between the two groups (P > 0.05). Conclusion It might be useful in predicting nonresponse to IVIG therapy in children with Kawasaki disease in more frequently experienced coronary artery lesion , cervical lymph node enlargement, sterile pyuria and higher levels of neutrophils, CRP, AST, ALT, LDH, TBIL and lower levels of albumin, high density lipoprotein, serum sodium concentration.
