High-Dose Intravenous Gamma-Globulin Therapy in Kawasaki Disease

106例川崎病病童，以四種不同方法治療，研究靜派注射高劑量丙種球蛋白對冠狀動脈病變的預防效果。第一組7例童，接受阿斯匹靈低劑量丙種球蛋白(130～200mg/kg/day)；第二組49例病童，接受阿斯匹靈及高劑量丙種球蛋白(201～400mg/kg/day)；第三組43例病童，只接受阿斯匹靈；第四組7例病童，只在急性期接受Acetaminophen治療。以雙面超音波心圖研究，主動脈攝影證實，在罹病四週內第一、二、三及四組冠狀動脈瘤的發生率分別爲42.9%, 49.0%, 44.2%及16.7%，而在平均11.4±8.2月追蹤期間，其冠狀動脈瘤的發生率分別爲28.6%, 18.4%, 16.4%, 16.7%，而直徑超過8毫米的巨型冠狀動脈瘤的發生率分別爲28.6%, 12.0%, 4.7%及14.3%。

關鍵字

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並列摘要

The efficacy for reduction of coronary aneurysm in Kawasaki disease was studied from 1984 to 1988 in Taiwan. One hundred and six children with Kawasaki disease were treated by one of the following regimens. regimen Ⅰ: aspirin and 130-200 mg/kg/day of intravenous gamma-globulin (group Ⅰ=7), regimen Ⅱ: 201-400 mg/kg/day of intravenous gamma-globulin with aspirin (group Ⅱ＝49) and regimen Ⅲ: aspirin alone (group Ⅲ＝43) and no treatment (group Ⅳ＝7). By using two-dimensional echocardiography and aortography, the coronary arterial aneurysms noted in group Ⅰ, Ⅱ, Ⅲ and Ⅳ were 42.9%, 49.0%, 44.2% and 16.7% respectively within 4 weeks of the illness and were 28.6%, 18.4%, 16.4% and 16.7% respectively during the follow-up period of 11.4±8,2 months. The incidence of coronary aneurysm was reduced significantly (p＜0.005) in patients with high-dose gamma-globulin therapy and with aspirin therapy alone. However, there was no difference between group Ⅱ and Ⅲ, probably due to delays in the time of start of prophylactic gamma-globulin therapy. There was also significant lower incidence of the giant coronary aneurysm in children with high dose gamma-globulin therapy and with aspirin therapy. (p＜0.05) The incidences of giant aneurysm in groups Ⅰ, Ⅱ, Ⅲ and Ⅳ were 28.6%, 2.0%, 4.7% and 14.3% respectively. These results suggest that even with delay in the time of start of prophylactic gamma-globulin therapy, it still can reduce the formation of giant coronary aneurysm.

並列關鍵字

intravenous r-globulin ； Kawasaki disease

國際替代計量

High-Dose Intravenous Gamma-Globulin Therapy in Kawasaki Disease

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