Qin Lijun, Saumu Mweri Tobbi, Wang Hongwei, Shi Hong, Hu Xiufen, Cheng Peixuan
Department of Pediatrics, Tongji Hosptal, Tongji Medical Collage, Huazhong University of Science and Technology, Wuhan 430030, Wuhan.
J Huazhong Univ Sci Technolog Med Sci. 2005;25(3):348-50, 370. doi: 10.1007/BF02828164.
In order to objectively evaluate the efficacy of intravenous gammaglobulin (IVIG) in the prevention and treatment of coronary artery lesion (CAL) in Kawasaki disease (KD) and the related factors influencing the IVIG efficacy, 314 children with KD were reviewed retrospectively and comparatively and were divided into IVIG plus aspirin group and ASA group. The occurrence and restoration of CAL in these two groups as well as many laboratory and clinical indexes including average hospital stay (days), total fever duration, defervescence time, platelet count, erythrocyte sedimentation rate, C reactive protein etc. were observed. The incidence of CAL was 39.5% in the children with KD. In the IVIG+ASA group, the incidence of CAL was 34.3% and 56.0% in ASA group respectively (P<0.001). The incidence of CAL was reduced in the group in which 2.0 g/kg or 1.0 g/kg IVIG was administered as compared with the group in which IVIG was administered at a dose < or =0.6 g/kg or > or =3.0 g/kg (P<0.05). CAL occurred less frequently when IVIG was administered at 3-10 days of the course than that when IVIG was administered < or =3 days or >10 days (P <0.05). About 13.4% of the CAL treated with IVIG was not recovered at the 12 th month of the course, mostly in the groups in which only ASA was administered and IVIG treatment was started 10 days later. The hospital stay (days), defervescence time, total fever duration, platelet count, erythrocyte sedimentation rate and C reactive protein were significantly reduced in IVIG+ ASA group as compared with those in the ASA group (P<0.05). IVIG treatment can remarkably shorten the course of patients with KD and decrease the incidence of CAL, but the efficacy of IVIG in the prevention and treatment of KD disease is not as expected by people, therefore, reevaluation of the practical efficacy of IVIG is required.
为客观评价静脉注射丙种球蛋白（IVIG）在预防和治疗川崎病（KD）冠状动脉病变（CAL）中的疗效以及影响IVIG疗效的相关因素，对314例KD患儿进行回顾性对比研究，分为IVIG加阿司匹林组和阿司匹林组。观察两组CAL的发生及恢复情况，以及包括平均住院天数、总发热持续时间、退热时间、血小板计数、红细胞沉降率、C反应蛋白等多项实验室及临床指标。KD患儿CAL发生率为39.5%。IVIG+ASA组CAL发生率分别为34.3%，ASA组为56.0%（P<0.001）。与IVIG剂量<或=0.6 g/kg或>或=3.0 g/kg的组相比，给予2.0 g/kg或1.0 g/kg IVIG的组CAL发生率降低（P<0.05）。病程3 - 10天给予IVIG时CAL发生频率低于病程<或=3天或>10天给予IVIG时（P <0.05）。IVIG治疗的CAL在病程第12个月约13.4%未恢复，大多在仅给予ASA且IVIG治疗开始于10天后的组。与ASA组相比，IVIG+ASA组住院天数、退热时间、总发热持续时间、血小板计数、红细胞沉降率及C反应蛋白均显著降低（P<0.05）。IVIG治疗可显著缩短KD患儿病程并降低CAL发生率，但IVIG在预防和治疗KD疾病中的疗效未达人们预期，因此，需要重新评估IVIG的实际疗效。
