The Influence Of Kawasaki Disease Curative Effect And Prognosis From Different Drug-delivery Ways Of Gamma Globulin

Objective:Collect the clinical data of 74 children with Kawasaki disease,to retrospectively analyze the influence and effect of different drug-delivery ways of gamma globulin to treat Kawasaki disease.Methods:A retrospective analysis of 74 cases of children diagnosed Kawasaki disease was conducted from January 2015 to September 2018 at the China-Japan Union Hospital of Jilin University.All cases were diagnosed by Kawasaki disease the fifth revised edition diagnostic criteria passed in2002 Japan excluding those who had congenital heart disease、serious infection、cure with no IVIG or before in hospital and lack whole data of clinical and laboratory inspection.According to different drug-delivery ways of gamma globulin,divided them into two groups.The observation group was given gamma globulin 2g/kg 1day,the control group was given gamma globulin 1g/kg 2days.The two groups children both were given aspirin 30-50mg/kg at acute phase,then cut back gradually after three days abatement of fever,two weeks later they were given 3-5mg/kg and need have a maintenance treatment for six to eight weeks,if there is coronary artery lesion,they need to treat until it disappears.Compare the differences of hospital stay 、 clinical symptoms(defervescence time,lymphadenectasis fade time,mucosal hyperemia fade time,indurative edema of palms and soles fade time)、laboratory indices(WBC、CRP、ESR)changing degree and therapeutic effect between two groups.Compare the coronary artery lesion by cardiac echocardiography after 3months、6 months、1 year、2 year in follow-up survey.Result:1、The observation group has a short hospital stay then the control group,the difference between the two groups has statistical significance(p<0.05).The observation group cuts down the time of defervescence、lymphadenectasis、mucosal hyperemia、indurative edema of palms and soles,compared to the control group,the difference between the two groups has statistical significance(p<0.05).2、There is no differences of inflammatory indicators between two groups before treating,after treating,CRP、ESR of them all significantly decrease,they are different in the same group before and after treament,but the reduce level of observation group is more than the control group,difference between the two groups has statistical significance(p<0.05).3、 The clinical efficiency of the observation group is 100%,the control group is 97.4%,the difference of clinical efficiency between the two groups has no statistical significance(p>0.05).4 、 All of cases have a 2 years follow-up survey.They review echocardiography at 3 month、6month、1 year and 2 year after leaving hospital.There are 1 case(2.8%)have coronary artery lesion of the observation group and 1 case(2.6%)of the control group.There is no significant difference of the coronary artery lesion incidence between two groups(p>0.05).Conclusion:1、 IVIG 2g/kg one day at acute phase of Kawasaki disease can significantly reduce hospital stay、improve clinical symptoms、decrease inflammatory indicators.2、There is no significant difference on the clinical efficiency and coronary artery lesion prognosis between the group IVIG 2g/kg one day with the group IVIG 1g/kg two days.