Furusho K, Kamiya T, Nakano H, Kiyosawa N, Shinomiya K, Hayashidera T, Tamura T, Hirose O, Manabe Y, Yokoyama T
Department of Paediatrics, Kokura Memorial Hospital, Japan.
Acta Paediatr Jpn. 1991 Dec;33(6):799-804. doi: 10.1111/j.1442-200x.1991.tb02611.x.
We studied the effect of gamma-globulin (IVGG) and aspirin (ASA) on the development of the coronary artery lesions (CAL) of Kawasaki disease (KD) in three different protocols. Within 29 days of the onset of KD the echocardiographic evidence of CAL had developed in 39-42% of the patients in the ASA group, but only in 13.7-20.8% of the patients treated with IVGG (200 or 400 mg/kg X 5). In long-term follow-up observation of CAL of these patients the evidence of CAL in both the ASA and the IVGG group regressed gradually; however, the residual rate of CAL was significantly low in the IVGG group at all times up to 24 months after onset. These facts suggest that when using IVGG for KD, we should select a dose of intact gamma-globulin, 1,000 mg/kg or more in total, to prevent the occurrence of CAL. We have demonstrated not only a significant reduction in the occurrence of CAL in patients treated with IVGG but a reduction in the residual rate of CAL for two years as compared with those treated by ASA.
我们采用三种不同方案研究了丙种球蛋白（IVGG）和阿司匹林（ASA）对川崎病（KD）冠状动脉病变（CAL）发展的影响。在KD发病29天内，ASA组39% - 42%的患者出现了CAL的超声心动图证据，而接受IVGG（200或400mg/kg×5）治疗的患者中只有13.7% - 20.8%出现了该证据。对这些患者的CAL进行长期随访观察发现，ASA组和IVGG组的CAL证据均逐渐消退；然而，在发病后长达24个月的所有时间里，IVGG组的CAL残留率均显著较低。这些事实表明，在使用IVGG治疗KD时，我们应选择总剂量为1000mg/kg或更高的完整丙种球蛋白剂量，以预防CAL的发生。我们已经证明，与接受ASA治疗的患者相比，接受IVGG治疗的患者不仅CAL的发生率显著降低，而且两年内CAL的残留率也有所降低。
