31例川崎病患儿脑脊液临床指标分析  

Analysis of cerebro-spinal fluid and clinical data from 31 children with Kawasaki disease

作　　者：郭倩倩[1] 王丽平[1] 徐让[1] 杨健萍[1] 孙锟[1] 陈笋[1] 

机构地区：[1]上海交通大学医学院附属新华医院小儿心血管科,上海200092

出　　处：《上海交通大学学报（医学版）》2013年第11期1480-1483,1487,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市科委医学引导类项目(124119a3900);国家重点基础研究发展计划"九七三"子课题(2010CB529501);上海交通大学医工交叉项目(YG2011MS08)~~

摘　　要：目的探讨患儿脑脊液(CSF)改变与急性期川崎病的关系,研究川崎病并发无菌性脑膜炎患儿脑电图及实验室指标的异常改变。方法从426例确诊的川崎病患儿中选择进行腰椎穿刺术病例,根据CSF中白细胞计数诊断无菌性脑膜炎,根据冠状动脉内径诊断冠状动脉扩张。分析无菌性脑膜炎组患儿的脑电图特征,比较无菌性脑膜炎组与白细胞计数正常组以及冠状动脉扩张组与冠状动脉非扩张组各项实验室指标的差异。结果共入选31例急性期川崎病,其中7例(22.6%)患儿CSF中白细胞计数升高(4例出现脑电图异常),8例(26.7%)患儿出现冠状动脉扩张。无菌性脑膜炎组患儿血中白细胞计数显著高于CSF白细胞计数正常组,差异有统计学意义(P=0.029);两组间其他实验室指标比较差异均无统计学意义(P>0.05)。冠状动脉扩张组与非扩张组之间各项实验室指标比较差异均无统计学意义(P>0.05)。结论川崎病患儿常见并发无菌性脑膜炎,脑电图异常比重大,血中白细胞计数过高对于川崎病患儿并发无菌性脑膜炎有提示意义。Objective To explore relationship between changes of cerebro-spinal fluid （CSF） and acute Kawasaki disease （KD）, and to study abnormalities of electroencephalograms and lab resuhs of KD patients with aseptic meningitis. Methods A total of 462 cases were collected while 35 patients among them once had lumbar puncture. Aseptic meningitis was diagnosed according to white blood cell count in CSF while coronary artery expansion was confirmed on the basis of the diameters. Electroencephalograms of the patients with aseptic meningitis were analyzed, and laboratory indexes were compared between aseptic meningitis group and white blood cell count normal group, and between coronary artery expansion group and coronary artery non-expansion group. Results Thirty-one children were finally involved in this study. Seven children （22.6%） had high white blood cell count including 4 children combined with abnormal electroencephalogram, while 8 （26.7%） children had coronary artery expansion. Compared to white blood cell count normal group, there was significantly higher white blood cell count in aseptic meningitis group （P = O. 029）, whereas no significant differences were found annmg other laboratory indexes （P 〉 O. 05）. And similar findings were found between coronary artery expansion group and coronary artery non-expansion group （P 〉 O. 05）. Conclusion The results suggested that KD patients with aseptic meningitis commonly had abnormal electroencephalogram, and high white blood cell count might be a hint for aseptic meningitis.

关 键 词：川崎病 脑脊液 脑电图 无菌性脑膜炎 

分 类 号：R725.4[医药卫生—儿科]