两种剂量丙种免疫球蛋白对川崎病患儿冠状动脉病变及血清基质金属蛋白酶含量影响的比较-东南大学学报医学版

两种剂量丙种免疫球蛋白对川崎病患儿冠状动脉病变及血清基质金属蛋白酶含量影响的比较

单位：天门市第一人民医院儿科, 湖北天门 431700

分类号：R726.199

出版年·卷·期（页码）：2015·34·第六期（942-945）

摘要：

目的:探讨静脉注射丙种免疫球蛋白(intravenous immune globulin,IVIG)两种剂量对川崎病患儿冠状动脉病变(CAL)及血清基质金属蛋白酶(MMP)检测量的影响.方法:将128例川崎病患儿随机分为IVIG 1g·kg^-1组与IVIG 2g·kg^-1组,分别予以相应剂量单次静脉注射,记录两组患儿总热程、退热时间、黏膜充血、手足肿胀和颈淋巴结肿大消退时间以及冠状动脉病变发生率.检测治疗前后两组患儿血清基质金属蛋白酶含量.结果:两组患儿的总热程、颈淋巴结肿大、手足肿胀、黏膜充血及发热消退时间等差异无统计学意义(P>0.05);IVIG 1g·kg^-1组CAL发生率(15.62%)略高于IVIG 2g·kg^-1组(14.06%),差异无统计学意义(P>0.05);治疗后两组患儿血清中基质金属蛋白酶-2与MMP-9较治疗前均明显减少,IVIG 1 g·kg^-1组MMP-2与MMP-9水平略高于IVIG 2g·kg^-1组,但差异无统计学意义(P>0.05).结论: 1g·kg^-1和2g·kg^-1 IVIG均可缩短川崎病病程,降低CAL发生率,减少血清中基质金属蛋白酶含量,减缓冠状动脉外细胞基质受损,但2g·kg^-1的IVIG临床疗效略优,可能为治疗川崎病的有效剂量.

Objective:To observe the effect of different dose of intravenous immunoglobulin on treatment coronary lesion and serum gelatinase in Kawasaki disease. Methods:128 cases Kawasaki disease children were randomly divided into Group IVIG 1g·kg^-1 and Group IVIG 2g·kg^-1,both groups were given single intravenous injection. Total fever duration,cervical lymph nodes, foot swelling, mucous congestion, fever subsiding time,and occurrence of coronary artery lesion (CAL) of both groups were recorded. Serum gelatinase MMP-2 and MMP-9 were detected .Results:There was no significant difference of total fever duration, cervical lymph nodes, foot swelling, mucous congestion, fever subsiding time in both groups (P>0.05). Occurrence of CAL in Group IVIG 1 g·kg^-1 was slightly higher than that in Group IVIG 2g·kg^-1(P>0.05) with no significant difference; After treatment,MMP-2 and MMP-9 group reduced obviously, MMP-2 and MMP-9 in Group IVIG 1 g·kg^-1 were slightly higher than that in Group IVIG 2g·kg^-1 (P>0.05).Conclusion:IVIG 1g·kg^-1 and IVIG 2g·kg^-1 can shorten the duration of Kawasaki disease,reduce the incidence of CAL, reduce serum gelatinase and coronary extracellular matrix damage, comparably IVIG 2g·kg^-1 is slightly more significantly effective, which may possibly be the effective dose for the treatment of Kawasaki disease.

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