国际医药卫生导报2025，Vol.31Issue(9)：1451-1456,6.DOI:10.3760/cma.j.cn441417-20241114-09009
川崎病患儿静脉注射免疫球蛋白耐药的影响因素及冠状动脉损害情况
Influencing factors of intravenous immunoglobulin resistance and coronary artery damage in children with Kawasaki disease
摘要
Abstract
Objective To investigate the influencing factors of intravenous immunoglobulin(IVIG)resistance and coronary artery damage in children with Kawasaki disease(KD).Methods A retrospective cohort study was conducted to analyze the clinical data of 205 KD children who received treatment in Yan'an University Affiliated Hospital from May 2021 to June 2024.They were all treated with IVIG.The children were divided into a drug-resistant group and a sensitive group according to whether drug resistance occurred,and the coronary artery damage after IVIG was recorded.Independent sample t test and x2 test were used for between-group comparison,and logistic regression analysis was used to analyze the influencing factors of IVIG resistance in KD children.Results Among the 47 children in the drug-resistant group,there were 21 boys and 26 girls,34 cases ≥2 years old and 13 cases＜2 years old.Among the 158 children in the sensitive group,there were 71 boys and 87 girls,58 cases ≥2 years old and 100 cases＜2 years old.There were statistically significant differences in the proportion of central nervous system damage,age of onset,platelet count(PLT),white blood cell count(WBC),peripheral blood neutrophil percentage(N),C-reactive protein(CRP),hemoglobin(Hb),albumin(ALB),serum ferritin(SF),and sedimentation rate between the two groups(all P＜0.05).Multivariate logistic regression analysis showed that age of onset ≥2 years old,low PLT,high CRP,low Hb,low ALB,high SF,and high sedimentation rate were independent risk factors for IVIG resistance in KD children(all P＜0.05).There was no statistically significant difference in the coronary artery damage between the two groups at the onset[42.55％(20/47)vs.41.14％(65/158)](P＞0.05).However,the coronary artery damage rate in the drug-resistant group was higher than that in the sensitive group at 1 week and 3 months after treatment[36.17％(17/47)vs.21.52％(34/158),29.79％(14/47)vs.15.82％(25/158)](both P＜0.05).Conclusions Age of onset ≥2 years old,low PLT,high CRP,low Hb,low ALB,high SF,and high sedimentation rate are independent risk factors for IVIG resistance in KD children.It is necessary to perform clinical management on the above factors to reduce the risk of IVIG resistance.In addition,the rate of coronary artery damage in the drug-resistant group is higher than that in the sensitive group at 1 week and 3 months after treatment.These findings provide an important reference for clinical identification of risk factors for IVIG resistance in KD children and prevention of coronary artery damage.关键词
川崎病/静脉注射免疫球蛋白/耐药/影响因素/冠状动脉损害/儿童Key words
Kawasaki disease/Intravenous immunoglobulin/Drug resistance/Influencing factors/Coronary artery damage/Children引用本文复制引用
刘庆,任文娟,钟红平..川崎病患儿静脉注射免疫球蛋白耐药的影响因素及冠状动脉损害情况[J].国际医药卫生导报,2025,31(9):1451-1456,6.基金项目
陕西省重点研发计划(2024SF-YBXM-307) Key R&D Program of Shaanxi Province(2024SF-YBXM-307) （2024SF-YBXM-307）
