Harada K
Department of Pediatrics, Nihon University, School of Medicine, Tokyo, Japan.
Acta Paediatr Jpn. 1991 Dec;33(6):805-10. doi: 10.1111/j.1442-200x.1991.tb02612.x.
A multicenter randomized controlled study was carried out to assess the effectiveness of different, doses and kinds of gamma-globulin in Kawasaki disease. Gamma globulin lowered the incidence of coronary artery abnormalities. The effect of gamma-globulin was dose dependent. The intact type was more effective than the pepsin treated type. To establish the indications for gamma-globulin, a study was made of patients who received neither gamma-globulin nor indomethacin and who, within nine days of onset of illness, satisfied at least four of the following criteria: (1) WBC: more than 12,000/mm; (2) platelet count: less than 35 X 10(4)/mm; (3) CRP: more than 3+; (4) Hct: less than 35%; (5) albumin: less than 3.5 g/dl (6) age: 12 months or less; (7) male sex. This prospective study is continuing. Of 143 children, 73.4% received gamma-globulin, and only two demonstrated small dilatations of the coronary arteries in children who did not receive gamma-globulin. These guidelines seem satisfactory to establish the indications for gamma-globulin in Kawasaki disease.
开展了一项多中心随机对照研究，以评估不同剂量和种类的γ球蛋白在川崎病中的疗效。γ球蛋白降低了冠状动脉异常的发生率。γ球蛋白的效果呈剂量依赖性。完整型比胃蛋白酶处理型更有效。为确定γ球蛋白的适应证，对既未接受γ球蛋白也未接受吲哚美辛治疗、且在发病9天内至少满足以下4项标准的患者进行了研究：（1）白细胞计数：超过12,000/mm；（2）血小板计数：低于35×10⁴/mm；（3）C反应蛋白：超过3+；（4）血细胞比容：低于35%；（5）白蛋白：低于3.5 g/dl；（6）年龄：12个月及以下；（7）男性。这项前瞻性研究仍在继续。143名儿童中，73.4%接受了γ球蛋白治疗，未接受γ球蛋白治疗的儿童中只有2名出现冠状动脉小扩张。这些指南似乎能令人满意地确定川崎病中γ球蛋白的适应证。
