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目的探讨丙种球蛋白治疗川崎病(KD)时患儿体温改变与发生冠状动脉病变的相关性。方法选择符合KD诊断标准的患儿88例,根据使用IVIG(剂量均为1g.kg-1.d-1,连用2d)后热退时间不同分为A(<12h)、B(12～24h)、C(>24～48h)、D(>48h,即IVIG耐药)4组,各组其他临床指标比较差异无统计学意义(P<0.01)。然后对各组6个月内超声心动图探查累计检出冠状动脉损伤(CAL)例数进行分析。结果病程前6个月各组累计发现CAL42例(47.7%)。其中A组9例(33.3%)、B组16例(51.6%)、C组12例(54.5%)、D组5例(62.5%),A、B、C、D各组CAL发病率逐渐升高,D组CAL发病率是A组的近2倍,但A组与B、C、D各组比较差异均无统计学意义(Pa>0.05)。结论应用IVIG后KD患儿CAL发病率随用IVIG治疗后热退时间的延长而逐渐升高。
Objective To investigate the relationship between temperature change and coronary artery disease in children with Kawasaki disease (KD) treated with gamma globulin. Methods A total of 88 children with KD diagnostic criteria were selected and divided into A (<12h), B (12 ~ 24h) according to the different thermal back-off time after IVIG (1g.kg-1.d-1, ), C (> 24 ~ 48h), D (> 48h, ie IVIG resistance). There was no significant difference in other clinical indexes among the groups (P <0.01). Then, the number of cases of coronary artery injury (CAL) detected by echocardiography within 6 months of each group was analyzed. Results In the 6 months before the course of the disease, CAL42 cases were found in all groups (47.7%). There were 9 cases in group A (33.3%), 16 cases in group B (51.6%), 12 cases in group C (54.5%) and 5 cases in group D (62.5% The incidence of CAL in group D was nearly 2 times of that in group A, but there was no significant difference between group A and groups B, C and D (P> 0.05). Conclusion The incidence of CAL in children with KD after IVIG treatment is gradually increased with the prolongation of thermal back-off time after IVIG treatment.