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目的探讨10d内已退热的川崎病(KD)患儿应用丙种球蛋白(IVGG)治疗的必要性以及不同剂量IVGG治疗对KD预后的影响。方法研究对象为1999-10—2005-10山东省菏泽市立医院收治的56例KD患儿,所有患儿均为10d内退热后确诊且无冠脉病变。按IVGG治疗剂量分成3组,A组(11例)用1g/kg,B组(26例)用2g/kg,C组(19例)未使用,余治疗相同。对其冠状动脉损害(CAL)情况进行对比。结果病程14~21d时发生CAL例数:A组2例(18·18%),B组4例(15·38%),C组16例(84·21%),A、B组比较差异无显著性意义(P>0·05);A、B组与C组之间差异有非常显著性意义(P<0·01)。随访0·5年CAL例数:A组1例(9·09%),B组1例(3·85%),C组11例(57·89%),A、B组比较差异无显著性意义(P>0·05),而A、B组与C组之间差异有非常显著性意义(P<0·01)。结论10d内一经确诊的KD无论是否已退热均应给予IVGG治疗,对已退热且无冠脉损害的患儿应用总量1g/kg IVGG治疗可以达到满意的效果。

Study on prognosis of Kawasaki disease treated with intravenous gamma globulin (IVGG) after abatement of fever

Objective To study the dose of IVGG in treating Kawasaki disease(KD) at defervescence and the necessity.Methods Clinical data of 56 cases of Kawasaki disease without coronary artery lesion(CAL) but with abatement of fever in 10 days were retrospectively analyzed.They were divided into three groups according to IVGG dosage:group A (1g/kg IVGG n=11),group B (2g/kgIVGG n=26)and C(blank n=19).CAL was observed at 14~21days and 0.5 year.Results Compared with group A and B,the rate of CAL was significantly higher (P<0.01)in group C at 14 ~21days and 0.5 year,while no difference between group A and B at the two stages(P>0.05).Conclusion In order to prevent CAL,KD children with confirmed diagnosis in 10 days should all be treated with IVGG whether with abatement of fever or not.The dose of 1g/kg IVGG would have satisfactory effects on KD children at defervescence.