静脉注射免疫球蛋白在急性类风湿性发烧:一个随机对照试验
L M Voss1, N J Wilson, J M Neutze
1Starship Children's Hospital, Auckland, New Zealand. ssinfect@ahsl.co.nz
Circulation
|February 7, 2001
概括
静脉注射免疫球蛋白 (IVIG) 并没有改善急性类风湿性发烧 (ARF) 患有心脏炎的患者的结局. 这项研究发现,在12个月的时间内,临床或心声学测量没有显著差异.
科学领域:
- 儿科 儿科 儿科
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 急性类风湿性发烧 (ARF) 是全球儿童获得心脏病的主要原因.
- 目前的治疗方法不会改变急性疾病的临床结果.
- 免疫学因素与ARF的发病有关,这表明像IVIG.IVIG这样的免疫调节剂可能发挥作用.
研究的目的:
- 调查静脉注射免疫球蛋白 (IVIG) 是否会改变ARF的自然史.
- 为了确定IVIG是否可以降低ARF患者心脏炎的程度和严重程度.
主要方法:
- 进行了一项前性,双盲,随机,安慰剂对照试验.
- 患者接受IVIG (1g/kg在1-2天,0.4g/kg在14,28天) 或安慰剂.
- 评估 (临床,实验室,心声) 在多个时间点进行,长达52周.
主要成果:
- 59名患者接受治疗;39名患者患有心炎和/或多关节炎.
- 在6周的炎症标志物 (ESR,急性阶段蛋白质) 的正常化中没有发现显著差异.
- 心脏结果,包括1年内膜卷入和吐严重程度,在IVIG和安慰剂组之间没有显著差异.
结论:
- 静脉注射免疫球蛋白 (IVIG) 没有改变急性类风湿性发烧 (ARF) 的自然史.
- 在12个月内,没有观察到临床,实验室或心声学参数的可检测差异.
- 在修改ARF心脏炎的结果方面,IVIG没有效果.
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