细菌感染在川崎病发病及冠状动脉损害中的作用研究  

Role of Infection in Development of Kawasaki Disease and Coronary Artery Leision

作　　者：李瑞燕[1] 李晓辉[2] 徐酉华[1] 周敏[2] 张砺[2] 李晋蜀[2] 

机构地区：[1]重庆医科大学附属儿童医院,重庆市400015 [2]四川省成都市儿童医院

出　　处：《中国全科医学》2010年第35期4002-4004,共3页Chinese General Practice

摘　　要：目的探讨细菌感染在川崎病(KD)发病中的作用及细菌感染与KD冠状动脉损害之间的关系。方法选取2002年1月—2008年12月住院的KD患儿266例,回顾性分析KD患儿血培养结果,不同年龄段KD患儿血培养阳性率,探讨血培养阳性与冠状动脉损害之间的关系。结果 266例KD患儿血培养阳性27例,阳性率为10.15%,其中革兰染色阳性菌7例,革兰染色阴性菌20例,血培养阴性239例。检出细菌16种。各不同年龄组血培养阳性率比较,差异有统计学意义(P<0.05);其中幼儿组(1～岁)、学龄前期组(3～岁)及学龄期组(≥6岁)血培养阳性率较婴儿组(<1岁)均明显升高,差异有统计学意义(P<0.05)。266例KD患儿180例行超声心动图检查,冠状动脉损害80例,占42.2%。180例行超声心动图检查的KD患儿血培养阳性22例,冠状动脉损害率为59.1%(13/22);血培养阴性158例,冠状动脉损害率为38.6%(61/158)。血培养阳性患儿冠状动脉损害发生率较血培养阴性患儿明显升高,差异有统计学意义(P<0.05)。结论细菌感染可能参与KD的发病,年长儿的血培养阳性率较婴儿明显增高,罹患KD的年长儿更需警惕是否合并感染。血培养阳性与冠状动脉损害发生有一定相关性。Objective To explore the role of infection in the development of Kawasaki disease（KD）to understand the relationship between infection and coronary artery lesion（CAL）caused by KD.Methods 266 KD patients hospitalized from Jan 2002 to Dec 2008 were enrolled to analyze retrospectively hemoculture outcome and its positive rate and the relationship of hemoculture to CAL.Results Twenty-seven had positive hemoculture in cluding 7 gram-negative bacteria,and 239 negative hemoculture（10.15%）.Sixteen species of pathogens were detected.There was significant difference in hemoculture positive rate between different age groups（P〈0.05）.Eighty of 180 KD patients receiving cardiac ultrasound had CAL（42.2%）,20 had hemoculture positive,CAL rate was 59.1%（13/22）;158 had hemoculture negative,CAL rate was 38.6%（61/158）.The incidence of CAL was higher in patients with hemoculture positive than in those with negative（P〈0.05）.Conclusion Bacterial infection may involved in the development of KD.The hemoculture positive ratio of ofinfantum was significantly lower than that of older children.During the acute stage of KD,there were certain correlation between positive hemoculture and CAL.

关 键 词：黏膜皮肤淋巴结综合征 川崎病 感染 

分 类 号：R725.9[医药卫生—儿科]