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目的分析评价不同剂量静脉注射丙种球蛋白(IVIG)对川崎病(KD)疗效的随机对照研究(RCT)。方法根据纳入和排除标准,从医学电子数据库中筛选相关RCT文献,应用Cochrane Handbook for Systematic Reviews of Intervention质量评价标准进行质量评价,用Review Manager5.0软件进行Meta分析。疗效判断指标为观察期内退热时间、住院时间、皮疹消退时间、血沉(ESR)、C-反应蛋白(CRP)和超声心动图检测冠状动脉病变情况。结果 用均差(MD)或比值比(OR)及其95%可信区间(CI)表示,以P<0.05为差异有统计学意义。结果 共有7项RCT入选。干预组IVIG1g/(kg.d),连用2 d使患者退热的时间比对照组400 mg/(kg.d)连用5 d或2g/(kg.d)快,两组差异有统计学意义[MD=-0.7,95%CI(-1.50,0.11),P<0.01];但在对冠状动脉损害影响方面,两者差异无统计学意义[OR=0.99,95%CI(0.48,2.05),P>0.05]。结论 1g/(kg.d)IVIG能有效地控制体温,但两者在冠状动脉瘤(CAA)发生率方面差异无统计学意义。
Objective To analyze the randomized controlled study (RCT) evaluating the curative effect of intravenous gamma globulin (IVIG) on KD in different doses. Methods Based on the inclusion and exclusion criteria, relevant RCTs were screened from the medical electronic database. The quality of the RCTs was evaluated using the Cochrane Handbook for Systematic Reviews of Intervention. Meta-analysis was performed using Review Manager 5.0 software. Efficacy indicators for the observation period of the antipyretic time, hospital stay, rash subsided time, ESR, C-reactive protein (CRP) and echocardiography coronary lesions. The results were expressed as mean difference (MD) or odds ratio (OR) and 95% confidence interval (CI), with a difference of P <0.05 was statistically significant. Results A total of seven RCTs were selected. Intervention group IVIG1g / (kg.d), 2d for patients with fever than the control group 400 mg / (kg.d) for 5 d or 2g / (kg.d) fast, the difference between the two groups was statistically significant (MD = -0.7,95% CI -1.50, 0.11, P <0.01). However, there was no significant difference between the two groups in the effect on coronary artery lesions (OR = 0.99,95% CI 0.48,2.05) , P> 0.05]. Conclusion 1g / (kg.d) IVIG can effectively control body temperature, but there is no significant difference between the two in the incidence of coronary aneurysm (CAA).