Abstract:
Objective
To compare and analyze the risk factors of Kawasaki disease with no response to venous injection of gamma globulin and to summarize the treatment experience.
Methods
A total of 384 cases of Kawasaki disease in children were treated in our hospital from Feb. 2013 to Oct. 2016, including 310 typical cases and 74 incomplete cases. These children were divided into two groups according to their reaction to the treatment of venous injection of gamma globulin: sensitive group (352 cases) and no-response group (32 cases).For these 32 cases, the injection was performed again, or pulse therapy of large dose of hormone was given as an anti-inflammation and expectant treatment.
Results
The incidence rate of no-response Kawasaki disease was 8.33%(32/384);fever was relieved at (14.1±1.1)d; after 2 weeks of treatment, WBC, PLT, ESR and CRP were decreased significantly, but C-reactive protein was still a little higher than normal［(15.3±3.4)mg/L］. Ultrasound ECG revealed 8 cases of coronary dilation, but there was no such complications as arrhythmia. The fever course, ESR, GPT, the fever time after first injection of gamma globulin and the time of first injection of gamma globulin in the no-response group were higher than those in sensitive group, while Hb level after treatment was lower than sensitive group, the difference being statistically significant(P<0.05).Fever course was an independent risk factor［OR=1.48, 95%CI（2.41～6.17）,P<0.001］.
Conclusion
Long time of fever may be an important reason for no-response to first-time venous injection of gamma globulin. Therefore, it is necessary to use venous injection of gamma globulin properly, select an appropriate time for injection and give timely anti-inflammation and antipyretic treatment.

Key words: Kawasaki disease, Gamma globulin, No-response Kawasaki disease, Risk factors, Child