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1、273临床研究静脉注射丙种球蛋白无反应型川崎病56例临床分析胡坚,张庆,傅松龄,龚方戚,朱卫华,解春红,汪伟摘要目的:分析静脉注射丙种球蛋白(IviG)无反应型川崎病患儿的临床特点方法:对2(X)7刁1至208扔期间在我院住院治疗的332例川崎病患儿进行病例回顾性分析结果:WIG无反应型川崎病共56例(占16.9%)IviG无反应型川崎病中男女性别比为4.09:1,明显高于WIG敏感川崎病1.38:1(尸<0.05)rVIG无反应型川崎病中有较严重冠状动脉扩张或冠状动脉瘤者n例(19.6%),明显高于WIG敏感川崎病(2.5%)(尸<0.05)川崎病患儿发生mG耐药的可能危险因素
2、有外周血白细胞中性粒细胞比例血红蛋白红细胞压积血小板C反应蛋白血沉血浆白蛋白乳酸脱氢酶等WIG无反应型川崎病患儿中3例通过复用IVIG后临床症状得以缓解,仅n例在复用WIG后症状仍不能控制而加用激素治疗结论:WIG无反应型川崎病较IvlG敏感川崎病更易发生冠状动脉病变复用IVIG及必要时加用激素对WIG无反应型川崎病治疗有较好疗效关键词川崎病;静脉注射丙种球蛋白无反应;临床特点;治疗Cli川calFeaturesinPatientsWithIutravenoush列Inunoglob加ResistantE渡wasaki肠se别犯HUJian,ZHANGQing,FUSo
3、ng一ling,GONGFang一单,ZHUWei七ua,XIEChun~hong,WANGWei.DepaItmeltOfCardiolo群扩几eChildren5Hospi回,ZhejiangU垃versitySchoolOfMedieine,H田lgzhou(3l0(刃3),Zhejiang,ChinaCorespon由嗯Author:GONGFang一单,Em苗1:gongfangqi@Zju.edu.enAbstr8Ctobjective:TOinvestigatetheeli苗ealfeaturesandriskfaetorsinpatients衍thinl泊wenousimm
4、unoglobin(IvIG)resistanKa~w二只只kidisease.Methods:AtotalOf332patientswithKawsakidiseasefromJanu呵20(y7toJ叻e以X)8tre川tedinourhosPi妞wereretro-sPeCtivelranalyZed.Result:Therwere56/332(16.9%)patientsfailedtoinitidWIG晓叻刀朋t.A功Ongthosep.tie刀ts,theratioofm司etofe-malewas409:l,thatwas51,ificantl,higherthanIVIGr
5、esponsiveKawas山diseasepatients(1.38;l),(P<0.05).The尹tientswithIVIGresistantKawas山diseasehadhigherandseverereorn娜arte可lesions(19.6%)than面eOfIVG花spsnsivepatients(2.5%),(p<0.05).ComparedwithIVGresponsivepatients,the娜sibleriskfactooforWIGresistantK姗aS山dis-easewerwhitebloodeel,neutIDphilratio,hemoglobul
6、in,hematoerit,Plateleteount,C曰沈ac丘,eprotein,e单broc外e汕mentationrate,山uminandlactaedehydrogenase,etc.Inmalepatienis,decreasedhematoctit助dd亡亡比朋记目山u面n面ghtberelatedtoIVIGresistant.Additionali面sionofIVIGefeetedinmostmGresistantpatients(33/56)声加m五d七atmentwasusedto11沙tientsinwhomtheadditionalinflisionofIV
7、IGhadnoefeets.Conclusion:几epaticntswithIviGresistantKawaS山diseaseshadthehigharri吸forc.旧训叮时.叮1.加细人d击丘叨习in-加幼onofWIGandsteIOldtreatme爪withantiplateletandantico理川antmedicationss玩附dg耐d介改.血p浦.t.初山p八Gre-5
