【摘要】 目的观察川崎病(Kawasaki,KD)的临床特征、大量静脉免疫球蛋白(Intravenous Immunoglobulin,IVIG)治疗前后实验室检查的变化以及随访结果。方法对29例KD患者临床资料、实验室检查和随访结果进行回顾性分析和总结。收集同期住院治疗24例非感染患者作为对照组,记录对照组血液学检查结果,并与KD组进行比较。结果①29例KD患者中,IVIG敏感型25例,IVIG无反应型4例;超声心动图结果显示,冠脉正常16例,冠脉扩张(Coronary Artery Dilation,CAD)9例,冠脉瘤(Coronary Artery Aneurism,CAA)4例。②与对照组比较,治疗前KD患者血白细胞(Write Blood Cell,WBC)、中性粒细胞百分比(neutrophilicgranulocyte,N%)明显增高,淋巴细胞百分比(lymphocyte,L%)明显降低,治疗后WBC、N%和L%与对照组比较无显著性差异。③与KD患者治疗前比较,治疗后WBC、N%和C反应蛋白(C-reactive protein,CRP)明显降低,L%明显升高,血沉(Erythrocyte Sedimentation Rate,ESR)变化不明显,血小板(Blood Platelet,PLT)不受治疗影响而逐渐升高。④22例KD患者进行随访,12例冠脉正常者无新发病变,8例CAD完全恢复正常,1例CAA病变加重,1例CAA不完全恢复。结论大剂量IVIG治疗KD效果满意,WBC、N%、L%和CRP短期内回复正常,可以作为反应急性期病情变化的指标。对IVIG无反应型KD须引起重视,以便及时采取积极有效的治疗措施。更多还原

【Abstract】 OBJECTIVE To study the clinic features,changes of laboratory examination induced by intravenous immunoglobulin(IVIG) and follow-up results of Kawasaki disease(KD).METHODS The clinic information,laboratory examination and follow-up results of 29 KD patients were reviewed.24 non-infectious patients were assigned into control group,and the laboratory examination result of controls was compared with KD group.RESULTS 25 of 29 KD patients were IVIG responders and 4 were IVIG non-responders.Echocardiography showed 16 cases of normal coronary artery,9 cases of coronary artery dilation(CAD),and 4 cases of coronary aneurysm(CAA).Before treatment,WBC and the proportion of neutrophil(N%) in KD group were higher than those of controls,while the proportion of lymphocytes(L%) was lower than that of control group.After treated by IVIG,the WBC,N% and L% returned to the control group level.In KD group,after IVIG treatment,WBC,N% and CRP decreased significantly,L% and PLT increased significantly,ESR had no change.22 KD patients were followed up.No new impairment occurred in 12 non-coronary artery lesion cases,8 CAD cases regressed completely,1 CAA extended,the other CAA regressed incompletely.CONCLUSION IVIG is an effective agent in the treatment of KD,WBC,N%,L% and CRP can be used to reflect conditions change in acute phase of KD.The doctors should pay attention to IVIG non-response KD in order to take active and effective treatment timely.更多还原