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目的分析静脉注射丙种球蛋白反应低下性川崎病的临床特征,探讨早期诊断相关因素,早期最佳治疗方法。方法将308例川崎病按对静脉注射丙种球蛋白的反应分为静脉注射丙种球蛋白反应正常组281例,静脉注射丙种球蛋白反应低下组27例,分析其病例及实验室数据,作统计学分析。结果反应低下川崎病占总例数的8.75%,两组中性粒细胞无明显差异,反应低下川崎病组,年龄,热程差异有统计学意义,WBC(14.9±9.0)×109/L、CRP(135.2±112.4)mg/L、ESR(91.2±17.1)mm/h、乳酸脱氢酶(LDH)(317.9±3.1)U/L明显高于反应正常组,Hb(104.3±17.1)g/L,白蛋白(Alb)(34.2±3.4)g/L,Hct(34.9±6.0)%,PLT(312±134)×109/L明显低下反应正常组,一次追加静脉注射丙种球蛋白有效率达37.8%,7例糖皮质激素应用效果良好,5例联合复合丹参可明改善症状,冠状动脉病变缓恢复正常。结论年龄小,发热时间长,实验室数据血WBC、CRP、ESR、乳酸脱氢酶(LDH)高,Hb,白蛋白(Alb),Hct L低,IgG治疗反应差,应成为反应低下性川崎病的重要指标,在追加静脉注射丙种球蛋白治疗基上联合应用糖皮质激素是一种良好的治疗方法 。
Objective To analyze the clinical features of Kawasaki disease caused by intravenous gammaglobemia and explore the related factors of early diagnosis and the best early treatment. Methods 308 cases of Kawasaki disease according to intravenous gamma globulin reaction was divided into intravenous gamma globulin reaction normal group 281 cases, intravenous gamma globulin reaction was low group 27 cases, analysis of case and laboratory data for statistical analysis. Results Low Kawasaki disease accounted for 8.75% of the total number of cases, no significant difference between the two groups of neutrophils, low response Kawasaki disease group, the difference was statistically significant age, fever, WBC (14.9 ± 9.0) × 109 / L, The serum levels of CRP in serum were significantly higher than those in normal group (104.2 ± 112.4 mg / L, 91.2 ± 17.1 mmol / L ESR, and 317.9 ± 3.1 U / L for lactate dehydrogenase L, Alb (34.2 ± 3.4) g / L, Hct (34.9 ± 6.0)% and PLT (312 ± 134) × 109 / L were significantly lower than those in the normal control group. The effective rate of intravenous injection of gamma globulin 37.8%, 7 cases of glucocorticoid application of good effect, 5 cases of combined compound Salvia can improve symptoms, coronary artery disease slowly returned to normal. CONCLUSIONS: The age, fever, and blood temperature are long. Laboratory data such as blood WBC, CRP, ESR, LDH, Hb, Alb, Hct L are low, IgG treatment response is poor, An important indicator of disease, the additional intravenous gamma globulin treatment combined with glucocorticoid is a good treatment.