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免疫球蛋白制剂影响川崎病患者的低钠血症。

Immunoglobulin preparations affect hyponatremia in Kawasaki disease.

机构信息

Department of Pediatrics, Kansai Medical University, 2-3-l Shin-machi, Hirakata-shi, Osaka 573 1191, Japan.

出版信息

Eur J Pediatr. 2010 Aug;169(8):957-60. doi: 10.1007/s00431-010-1155-1. Epub 2010 Feb 18.

Abstract

Hyponatremia frequently occurs in Kawasaki disease (KD). The aim of this study was to investigate the effect of Na content of the intravenous immunoglobulin (IVIG) preparation on serum Na levels in KD. Seventy-eight subjects, of whom 27 had hyponatremia, were split up into two groups: group A receiving IVIG preparations containing high Na (0.9%) and group B receiving IVIG preparations containing trace Na. While the data before IVIG therapy revealed no significant differences in the median serum Na between the groups, an administration of IVIG preparations increased the serum levels of Na in group A (P < 0.01) but not in group B (P > 0.05). Furthermore, the median serum Na level was significantly higher in group A than that in group B (139.0 vs 137.0 mEq/L, respectively, P < 0.01). No significant difference was found in the prevalence of coronary artery lesions between the groups. In conclusion, we should keep it in mind that the IVIG products without Na have an adverse affect on hyponatremia in KD though their efficacy seems to be equivalent to those containing high Na.

摘要

低钠血症在川崎病(KD)中很常见。本研究旨在探讨静脉注射免疫球蛋白(IVIG)制剂中钠含量对 KD 患者血清钠水平的影响。78 例患者,其中 27 例有低钠血症,分为两组:A 组接受含高钠(0.9%)的 IVIG 制剂,B 组接受含微量钠的 IVIG 制剂。IVIG 治疗前,两组患者血清钠中位数无显著差异,但 A 组 IVIG 制剂治疗后血清钠水平升高(P<0.01),B 组则无显著变化(P>0.05)。此外,A 组患者血清钠中位数明显高于 B 组(分别为 139.0 和 137.0 mEq/L,P<0.01)。两组间冠状动脉病变发生率无显著差异。总之,我们应该记住,尽管不含钠的 IVIG 产品的疗效似乎与含高钠的产品相当,但它们对 KD 中的低钠血症有不利影响。

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