THE TREATMENT OF KAWASAKI SYNDROME WITH INTRAVENOUS GAMMA-GLOBULIN
THE TREATMENT OF KAWASAKI SYNDROME WITH INTRAVENOUS GAMMA-GLOBULIN
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DOI：
10.1056/nejm198608073150601
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发表时间：
1986-08-07
影响因子：
158.5
通讯作者：
MELISH, ME
中科院分区：
文献类型：
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作者：
NEWBURGER, JW;TAKAHASHI, M;MELISH, ME
在一项多中心随机试验中，我们比较了静脉注射丙种球蛋白加阿司匹林与阿司匹林单独使用在降低急性川崎综合征患儿冠状动脉异常发生率方面的疗效。随机分配到丙种球蛋白组的儿童接受静脉注射丙种球蛋白，每天每公斤体重400毫克，连续4天；两个治疗组都服用阿司匹林，在发病的第14天每天每公斤100毫克，然后每天每公斤3到5毫克。二维超声心动图是由两个或两个以上的读者盲目和独立地解释。入组两周后，阿司匹林组78名儿童中有18名（23%）出现冠状动脉异常，而丙种球蛋白组75名儿童中有6名（8%）出现冠状动脉异常（P = 0.01）。入组7周后，79名服用阿司匹林的儿童中有14名（18%）出现异常，79名服用丙种球蛋白的儿童中有3名（4%）出现异常（P = 0.005）。没有儿童因接受丙种球蛋白而出现严重不良反应。我们的结论是，在川崎综合征病程早期给予高剂量静脉注射丙种球蛋白是安全有效的，可以降低冠状动脉异常的发生率。
We compared the efficacy of intravenous gamma globulin plus aspirin with that of aspirin alone in reducing the frequency of coronary-artery abnormalities in children with acute Kawasaki syndrome in a multicenter, randomized trial. Children randomly assigned to the gamma globulin group received intravenous gamma globulin, 400 mg per kilogram of body weight per day, for four consecutive days; both treatment groups received aspirin, 100 mg per kilogram per day through the 14th day of illness, then 3 to 5 mg per kilogram per day. Two-dimensional echocardiograms were interpreted blindly and independently by two or more readers. Two weeks after enrollment, coronary-artery abnormalities were present in 18 of 78 children (23 percent) in the aspirin group, as compared with 6 of 75 (8 percent) in the gamma globulin (P = 0.01). Seven weeks after enrollment, abnormalities were present in 14 of 79 children (18 percent) in the aspirin group and in 3 of 79 (4 percent) in the gamma globulin group (P = 0.005). No child had serious adverse effects from receiving gamma globulin. We conclude that high-dose intravenous gamma globulin is safe and effective in reducing the prevalence of coronary-artery abnormalities when administered early in the course of Kawasaki syndrome.