许阳琼 刘国桥

[摘要]目的觀察丙种球蛋白联合阿司匹林治疗川崎病的效果与安全性。方法将2018年6月至2020年5月在孝感市妇幼保健院确诊并接受治疗的70例川崎病患儿按照治疗方案不同分为对照组（ n=35）和观察组（ n=35）。对照组予以阿司匹林治疗，观察组采取丙种球蛋白与阿司匹林联合的治疗方案。比较症状改善时间、血清炎性因子水平、临床疗效及不良反应。结果观察组患儿各症状改善时间均短于对照组，差异有统计学意义（ P <0.05）;治疗前两组患儿各血清炎性因子水平比较差异无统计学意义（ P >0.05），治疗后观察组患儿红细胞沉降率（ESR）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、C 反应蛋白（CRP）水平均低于对照组，差异有统计学意义（ P <0.05）;观察组治疗总有效率为94.29%，高于对照组的77.14%，差异有统计学意义（ P <0.05）;两组不良反应中头晕和冠状动脉病变的发生率较低，差异无统计学意义（ P >0.05）。结论在川崎病治疗中联合丙种球蛋白和阿司匹林可获得较为理想的疗效，有利于减轻炎症，症状改善，且不良反应少。

[关键词]川崎病;阿司匹林;丙种球蛋白;炎性因子;安全性

[中图分类号] R725.4 [文献标识码] A  [文章编号]2095-0616（2021）22-0086-04

Observation on the effect and safety of gamma globulin and aspirin on children with Kawasaki disease

XU  Yangqiong   LIU  Guoqiao

Department of Pediatrics， Maternal and Child Health Hospital of Xiaogan， Hubei， Xiaogan 432000， China

[Abstract] Objective To observe the efficacy and safety of gamma globulin combined with aspirin in treating Kawasaki disease. Methods A total of 70 children with Kawasaki disease diagnosed and treated in Maternal and Child Health Hospital of Xiaogan from June 2018 to May 2020 were divided into control group （n=35） and observation group （n=35） according to different treatment schemes. The control group was treated with aspirin， while the observation group was treated with gamma globulin combined with aspirin. The symptom improvement time， serum inflammatory factor level， clinical efficacy and adverse reactions were compared. Results The improvement time of symptoms in the observation group was shorter than that in the control group， with statistically significant difference （P <0.05）. There was no significant difference in serum inflammatory factors between the two groups before treatment （P >0.05）. After treatment， the erythrocyte sedimentation rate （ESR）， interleukin-6（IL-6）， tumor necrosis factor-α（TNF-α）， and C reactive protein （CRP） were lower than those of the control group， with statistically significant differences （P <0.05）. The total effective rate of observation group was 94.29%， which was higher than that of control group （77.14%）， with statistically significant difference （P <0.05）. The incidence of adverse reactions of dizziness and coronary artery disease was lower in the two groups， with no statistically significant difference （P >0.05）. Conclusion In the treatment of Kawasaki disease， the combination of gamma globulin and aspirin can obtain ideal curative effect， which is beneficial to reduce inflammation， improve symptoms and have few adverse reactions.

[Key words] Kawasaki disease; Aspirin; Gamma globulin; Inflammatory factor; Safety

小儿川崎病是好发于5岁以下儿童群体的一类心血管系统疾病，至今病因不明，发病率逐年升高，部分学者认为川崎病和感染有关，研究死亡病例过程中，发现此病和免疫调节系统损伤、血管炎的发生有关[1]，且人群不同，病因也存在差异，对冠状动脉有严重的损害性，影响生长发育，是后天性心脏病发生的原因之一，甚至危及生命安全，需早期确诊并采取治疗方案[2-3]。目前小儿川崎病主要是采取药物治疗，部分研究指出，阿司匹林与丙种球蛋白联合有良好疗效，阿司匹林属于消炎解热药物，丙种球蛋白属于免疫球蛋白，主要用于免疫力的提升。……