不同剂量免疫球蛋白治疗川崎病：疗效和安全性的荟萃分析。
Treatment of Kawasaki disease by different doses of immunoglobulin: a meta analysis of efficacy and safety.
机构信息
Department of Pediatrics, First Clinical Medical College of Lanzhou University, Lanzhou 730000, China.
出版信息
Transl Pediatr. 2012 Oct;1(2):99-107. doi: 10.3978/j.issn.2224-4336.2012.04.05.
OBJECTIVE
To assess the efficacy and safety of different doses of immunoglobulin in the treatment of Kawasaki disease (KD).
METHODS
The papers related to the treatment of KD were electronically searched in the databases including PubMed, EMBASE, Cochrane Library, CNKI, VIP and Wanfang. Randomized clinical trials (RCT) on the treatment of KD with different doses of immunoglobulin were included and assessed for quality. A Mata analysis was performed by RevMan 5.0.
RESULTS
Twenty-eight RCTs involving 2,596 cases were included. The results of Meta analysis showed that there were no significant differences in the incidences of coronary artery injuries at various phases, adverse reactions, and fever disappearance time between the immunoglobulin treatment groups at the doses of 1 g/(kg•d) for 1-2 days or 2 g/(kg•d) for single use. The fever disappearance time in the immunoglobulin treatment group at the dose of 1 g/(kg•d) for 1-2 days was significantly shorter than that in the immunoglobulin treatment group at the dose of 400 mg/(kg•d) for 4-5 days, but there were no significant differences in the incidences of coronary artery injuries at the acute phase and 6 months after treatment and in the adverse effects between the two groups. The incidence of coronary artery injuries at the acute phase and 6 months after treatment was significantly lower and the fever disappearance time was significantly shorter in the immunoglobulin treatment group at the dose of 2 g/(kg•d) for single use than those in the immunoglobulin treatment group at the dose of 400 mg/(kg•d) for 4-5 days, but there were no significant differences in the incidences of coronary artery injuries at the subacute phase and 12 months after treatment and adverse effects between the two groups.
CONCLUSIONS
There are similar efficacy for KD between the immunoglobulin treatment groups at the doses of 1 g/(kg•d) for 1-2 days and 2 g/(kg•d) for single use. The fever disappearance time in the two groups is shorter than that in the treatment group at the dose of 400 mg/(kg•d) for 4-5 days.
目的
评估不同剂量免疫球蛋白治疗川崎病（KD）的疗效和安全性。
方法
电子检索PubMed、EMBASE、Cochrane 图书馆、中国知网、维普及万方数据库中与 KD 治疗相关的文献，纳入不同剂量免疫球蛋白治疗 KD 的随机对照试验（RCT），并进行质量评价。采用 RevMan 5.0 软件进行 Meta 分析。
结果
共纳入 28 项 RCT，涉及 2596 例患者。Meta 分析结果显示，1 g/（kg·d）×12 天与 2 g/（kg·d）单次使用组在各期冠状动脉损伤发生率、不良反应及退热时间方面差异均无统计学意义；1 g/（kg·d）×12 天组退热时间短于 400 mg/（kg·d）×45 天组，但两组在急性期及治疗后 6 个月冠状动脉损伤发生率及不良反应方面差异均无统计学意义；2 g/（kg·d）单次使用组急性期及治疗后 6 个月冠状动脉损伤发生率更低，退热时间更短，与 400 mg/（kg·d）×45 天组比较差异均有统计学意义（P<0.05），但两组在亚急性期及治疗后 12 个月冠状动脉损伤发生率及不良反应方面差异均无统计学意义（P>0.05）。
结论
1 g/（kg·d）×12 天与 2 g/（kg·d）单次使用两组疗效相当，退热时间均短于 400 mg/（kg·d）×45 天组。
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