Clinical observation of methylprednisolone sodium succinate combined with human immunoglobulin in the treatment of Kawasaki disease in children
Objective:To explore the therapeutic effects of methylprednisolone sodium succinate combined with human immunoglobulin in children with Kawasaki disease(KD).Methods:According to the random number table method,80 children with KD admitted to our hospital from May 2020 to May 2023 were divided into two groups,with 40 cases in each group.Both groups received basic symptomatic treatment,including adjustment of water and electrolyte balance,fever re duction,and oral aspirin enteric-coated tablets 50 mg/(kg·d),twice a day.Subsequently,according to the changes in the temperature of the child,the drug dosage was moderately reduced,and the dose was reduced to 5 mg/(kg·d)twice a day after about two weeks.to 6～8 weeks after the onset of the disease,if the symptoms disappeared and the blood pattern returned to normal,the drug was stopped.The control group was treated with 2 g/(kg·d)of intravenous human immunoglobulin based on the above treatment plan and was administered intravenous infusion once,8～12 h,at an initial rate of 20 drops/min.If no adverse reactions occurred after 15 min,the infusion rate was accelerated and the fastest infusion rate was no more than 60 drops/min.After two days of administration,the children whose body temperature was still above 38℃were given a second intravenous infusion of human immunoglobulin.In addition to the control group,the study group was treated with methylprednisolone sodium succinate 2 mg/(kg·d),twice a day.After 5 days of intravenous infusion,the treatment was changed to o ral methyl prednisolone tablets 2 mg/(kg·d)twice daily for two consecutive weeks.Clinical efficacy,clinical symptom resolution time,laboratory indicators(white blood cell count(WBC),platelet count(PLT),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),helper T lymphocyte levels,and incidence of adverse reactions were compared between the two groups.Results:The total efficacy rate in the study group was higher than that in the control group(P＜0.05).The disappearance times of mucosal congestion,fever,rash,and hard edema in the study group were shorter than those in the control group(P＜0.05).Before treatment,there was no statistically significant difference in the levels of laboratory indicators between the two groups(P＞0.05).Laboratory indicators in the study group were lower than those in the control group after treatment,and the levels of laboratory indicators were lower than those before treatment(P＜0.05).Before treatment,there was no statistically significant difference in the levels of helper T lymphocytes and coronary artery diameter between the two groups(P＞0.05).After treatment,Th1 and Th1/Th2 levels in the study group were higher than those in the control group,while Th2 levels were lower than those in the control group.The coronary artery diameter was smaller than that in the control group(P＜0.05).After treatment,Th1 and Th1/Th2 ratios were higher than before treatment,while Th2 and coronary artery diameters were smaller than before treatment(P＜0.05).There were no significant differences in adverse reactions between groups(P＞0.05).Conclusion:The combination of methylprednisolone sodium succinate and human immunoglobulin has a significant therapeutic effect on pediatric KD,which is beneficial for accelerating symptom recovery,improving laboratory indicators,inhibiting inflammatory reactions,regulating immune function,and reducing side effects.The medication is relatively safe.
kawasaki disease in childrenmethylprednisolone sodium succinatehuman immunoglobulinhelper T lymphocytescoronary artery diameter
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