【摘要】 目的观察糖皮质激素联合乌司他丁治疗小儿川崎病的短期疗效。方法选取82例川崎病患儿,根据患儿家属意愿分为观察组(n=44)与对照组(n=38)。观察组采取糖皮质激素联合乌司他丁治疗,对照组采取阿司匹林联合大剂量静脉注射丙种球蛋白(IVIG)治疗。比较2组治疗前后的冠状动脉内径分级、治疗24和48h的体温恢复情况,治疗前及治疗后1周的血清C反应蛋白(CRP)、血小板计数(PLT)、血沉(ESR)和外周血白细胞(WBC)水平,住院花费及药品花费。结果治疗前,2组的冠状动脉内径分别为2.97±0.81和2.89±0.90mm,差异无统计学意义。治疗8周后,观察组冠状动脉内径减小至2.51±0.74mm,对照组减小至2.55±0.51mm,治疗前后差异均有统计学意义(t=2.781,P=0.007;t=2.026,P=0.046)。2组治疗前后的冠状动脉内径分级差异均无统计学意义(P>0.05)。观察组治疗48h内退热率为100%,显著高于对照组的86.84%(P<0.05)。观察组退热时间、住院花费与药品花费分别为17.52±4.20h、0.73±0.18万元和0.33±0.09万元,显著低于对照组26.41±5.94h、1.08±0.23万元和0.68±0.13万元(P<0.05)。2组治疗后1周及2周的血清CRP和ESR均较治疗前显著降低(P<0.05),PLT较治疗前显著升高(P<0.05)。观察组治疗后1周及2周的ESR显著低于对照组(P<0.05),WBC显著高于对照组(P<0.05)。结论糖皮质激素联合乌司他丁治疗小儿川崎病与IVIG短期疗效相当,且患儿退热更快,与IVIG相比住院花费与药物花费大幅减少,经济性高。更多还原

【Abstract】 Objective To observe the short-term efficacy of glucocorticoid combined with ulinastatin in children with Kawasaki disease.Methods A total of 82 children with Kawasaki disease were selected and divided into observation group(n=44)and control group(n=38)according to the will of family members.The observation group received glucocorticoid combined with ulinastatin for treatment,while the control group was treated with aspirin combined with high-dose intravenous gamma globulin(IVIG).The coronary artery diameter grading before treatment and 8weeks after treatment,the body temperature recovery of treatment for 24 and 48h,the levels of C-reactive protein(CRP),Platelet count(PLT),erythrocyte sedimentation rate(ESR)and peripheral white blood cells(WBC)before treatment and 1week after treatment,the hospitalization costs and drug costs were compared between the 2groups.Results There was no statistically significant difference in the coronary artery diameter between the observation group and the control group 2.97±0.81 vs 2.89±0.90 mm before treatment(P<0.05).At the 8th week after treatment,the coronary artery diameter was reduced to 2.51±0.74 mm in the observation group and 2.55±0.51 mm in the control group.The difference was statistically significant(t=2.781,P=0.007;t=2.026,P=0.046).There was no significant difference in coronary artery diameter grading between the 2groups before and after treatment(P>0.05).The evacuation rate was 100%in the observation group at 48 hafter treatment,which was significantly higher than 86.84%in the control group(P<0.05).The body temperature recovery time,hospitalization costs and drug costs were 17.52±4.20 h,0.73±0.18 million and 0.33±0.09 million in the observation group,which significantly lower than 26.41±5.94 h,1.08±0.23 million and 0.68±0.13 million in control group(P<0.05).The levels of serum CRP and ESR of the 2groups after treatment were significantly lower than those before treatment(P<0.05).The levels of PLT of the 2groups were significantly higher than those before treatment(P<0.05).The levels of ESR at 1week and 2weeks after treatment were significantly lower than those in the control group(P<0.05),WBC was significantly higher than those in the control group(P<0.05).Conclusion The glucocorticoid combined with ulinastatin in children with Kawasaki disease can achieve the similar short-term efficacy to IVIG with the characteristics of faster antipyretic,lower drug costs and shorter hospitalization.更多还原