Hsu C H, Chen M R, Hwang F Y, Kao H A, Hung H Y, Hsu C H
Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.
Pediatr Infect Dis J. 1993 Jun;12(6):509-12. doi: 10.1097/00006454-199306000-00010.
In order to delineate the efficacy of plasmin-treated intravenous gamma-globulin (IVGG) in the treatment of Kawasaki syndrome, we compared the frequency of coronary artery abnormalities in children treated or not with IVGG for Kawasaki syndrome. Among 291 cases of Kawasaki syndrome diagnosed during the period of 1987 to 1991 without coronary abnormalities within 10 days of the onset of illness, 128 were treated with IVGG and aspirin and were compared with 163 treated with aspirin alone. IVGG was given in a dosage of 400 mg/kg/day for 4 consecutive days. The detection of coronary abnormalities was monitored by two dimensional echocardiography. Two weeks after enrollment coronary artery abnormalities were present in 37 (22.7%) of 163 children in the aspirin group and in 9 (9%) of 128 in the gamma-globulin group (P < 0.05). Seven weeks after enrollment, abnormalities were present in 20 (12.3%) of 163 children in the aspirin group and in 6 (4.6%) of 128 in the IVGG group (P < 0.05). We conclude that plasmin-treated IVGG is effective in reducing the prevalence of coronary artery abnormalities in Kawasaki syndrome and suggest a predominant role of the Fc gamma fragment of IgG in the therapeutic effect.
为了阐明纤溶酶处理的静脉注射丙种球蛋白（IVGG）治疗川崎病的疗效，我们比较了接受或未接受IVGG治疗的川崎病患儿冠状动脉异常的发生率。在1987年至1991年期间确诊的291例川崎病病例中，发病10天内无冠状动脉异常，其中128例接受IVGG和阿司匹林治疗，并与163例仅接受阿司匹林治疗的患儿进行比较。IVGG的给药剂量为400mg/kg/天，连续给药4天。通过二维超声心动图监测冠状动脉异常情况。入组两周后，阿司匹林组163例患儿中有37例（22.7%）出现冠状动脉异常，丙种球蛋白组128例中有9例（9%）出现异常（P<0.05）。入组七周后，阿司匹林组163例患儿中有20例（12.3%）出现异常，IVGG组128例中有6例（4.6%）出现异常（P<0.05）。我们得出结论，纤溶酶处理的IVGG可有效降低川崎病冠状动脉异常的发生率，并提示IgG的Fcγ片段在治疗效果中起主要作用。
