与川崎病需要额外静脉注射γ-球蛋白治疗相关的危险因素。

Risk factors associated with the need for additional intravenous gamma-globulin therapy for Kawasaki disease.

作者信息

Muta Hiromi, Ishii Masahiro, Furui Jun, Nakamura Yosikazu, Matsuishi Toyojiro

机构信息

Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.

出版信息

Acta Paediatr. 2006 Feb;95(2):189-93. doi: 10.1080/08035250500327328.

DOI:10.1080/08035250500327328

PMID:16449025

Abstract

AIM

To investigate the characteristics of patients with Kawasaki disease who needed intravenous gamma-globulin (IVGG) re-treatment.

METHODS

Using the database of the 17th nationwide survey in Japan, a total 11,366 patients were identified and analysed (1,855 re-treatment patients and 9,511 responders).

RESULTS

Multivariate logistic regression analysis showed that male sex (odds ratio (OR) 1.26; 95% CI 1.14-1.40), complete cases (OR 1.39; 95% CI 1.07-1.80), recurrence (OR 1.47; 95% CI 1.15-1.88), IVGG treatment within 4 d of illness (OR 2.05; 95% CI 1.84-2.27), daily dose of initial IVGG less than 1,000 mg/Kg (OR 0.54; 95% CI 0.48-0.61), exanthema (OR 2.03; 95% CI 1.62-2.56), lips and oral lesions (OR 1.57; 95% CI 1.24-1.98), peripheral extremities changes (OR 1.85; 95% CI 1.54-2.22), and cervical lymphadenopathy (OR 1.89; 95% CI 1.66-2.16) were independent risk factors associated with the need for IVGG re-treatment.

CONCLUSION

Male sex, recurrence, and treatment with IVGG at a dose of 1,000 mg/d or less within 4 d of illness onset are independent risk factors associated with the need for IVGG re-treatment.

摘要

目的

研究需要静脉注射丙种球蛋白（IVGG）再次治疗的川崎病患者的特征。

方法

利用日本第17次全国性调查数据库，共识别并分析了11366例患者（1855例再次治疗患者和9511例反应者）。

结果

多因素logistic回归分析显示，男性（比值比（OR）1.26；95%置信区间1.14 - 1.40）、完全病例（OR 1.39；95%置信区间1.07 - 1.80）、复发（OR 1.47；95%置信区间1.15 - 1.88）、发病4天内接受IVGG治疗（OR 2.05；95%置信区间1.84 - 2.27）、初始IVGG每日剂量低于1000mg/Kg（OR 0.54；95%置信区间0.48 - 0.61）、皮疹（OR 2.03；95%置信区间1.62 - 2.56）、嘴唇和口腔病变（OR 1.57；95%置信区间1.24 - 1.98）、外周肢体变化（OR 1.85；95%置信区间1.54 - 2.22）以及颈部淋巴结病（OR 1.89；95%置信区间1.66 - 2.16）是与IVGG再次治疗需求相关的独立危险因素。