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1、丙种球蛋白非敏感性川崎病的临床分析作者：廖志勤，杨少芬，李素作者单位：广东省湛江市第二人民医院儿科，广东湛江524003【摘要】冃的：分析静脉注射丙种球蛋白(IVIG)对川崎病(KD)治疗不敏感的临床特点。方法：回顾性分析122例KD住院患儿的临床资料，按标准分为IVIG敏感性KD组107例及IVIG非敏感性KD组15例，对其进行组间对比分析。结果：IVIG非敏感性KD组共15例，占总例数的12.3%,两组病例年龄、性别无明显差异(P>0.05)oIVIG非敏感性KD组的血红蛋白(Hb)血浆白蛋白(ALB)均明
2、显低于IVIG敏感性KD组，屮性粒细胞比例(N)明显高于IVIG敏感性KD组(Pv0・05)。IVIG非敏感性KD组患儿中有中度以上冠状动脉扩张或冠状动脉瘤者2例⑵15,13.3%),明显高于IVIG敏感性KD组⑵107,1.9%)(P<0.05)oIVIG非敏感性KD组患儿中9例通过复用IVIG后临床症状得以缓解，仅3例在复用IVIG后症状仍不能控制而加用激素治疗。结论：贫血、低蛋白血症、中性粒细胞比例增高是引起IVIG非敏感性KD组发生的可能因素，临床中对于这些患儿应了重视并进一步复用IVIG治疗，必要时在
3、抗凝基础上加用激素治疗以减少冠状动脉的损伤。【关键词】黏膜皮肤淋巴结综合征丙种球蛋白类阿司匹林儿童ClinicalanalysisofnonsensitivetreatmentwithimmunoglobulinforkawasakidiseaseLIAOZhiqin,YANGShaofen,LISuDepartmentofPediatrics,No.2People'sHospitalofZhanjiang,GuangdongProvinceZhanjiang524003,China[ABSTRACT]Obje
4、ctive:ToanalyzetheclinicalpropertiesofnonsensitivetreatmentofKawasakidisease(KD)withintravenousinjectionofimmunoglobulin(IVIG).Methods:Clinicaldatafrom122casesofhospitalizedKDchildrenwereanalyzedretrospectively.PatientsweredividedintoIVIGsensitivegroup(n=107
5、)andnonsensitivegroup(n=15).Thedifferencesinclinicalindicatorswerecomparedandanalyzedbetweenthetwogroups・Results:Therewasnosignificantdifferenceinageandsex(P>0.05).Comparedwiththehemoglobin(Hb)andplasmaalbumin(ALB)levelsinthesensitivegroup,thoseinthenonsensi
6、tivegroupweresignificantlylowerbutneutrophilicgranulocyteratiowassignificantlyhigher(P<0.05).Inthenonsensitivegroup,moderateorabovecoronaryarteriectasisorcoronaryaneurysmwasfoundin2cases(2/15,13.3%),significantlyhigherthanthoseinthesensitivegroup(2/107,1.9%)
7、(P<0.05).Clinicalsymptomswerealleviatedin9casesinthenonsensitivegroupafterreadministrationofIVIG,butnotin3cases・These3casesreceivedhormonetherapy.Conclusion:Anemia,albuminemia,increasedratioofneutrophilicgranulocytesmaybethefactorsresultinginnonsensitivityof
8、KDtoIVIG.Inclinicalpractice,thesechildpatientsshouldbetreatedbyIVIGandanticoagulation,combinedwithhormonetherapyshouldalsobeemployedwhennecessarytoattenuatecoronaryarteryinjuries.［KEYWORDS］Mucoc
