婴儿川崎病冠状动脉损伤危险因素分析  

Risk factors of coronary artery injury in infant Kawasaki disease

作　　者：张小平[1] 杨蕊华[1] 王俊英[1] 崔涛[1] 景迎春 刘丽华 Zhang Xiaoping;Yang Ruihua;Wang Junying;Cui Tao;Jing Yingchun;Liu Lihua(Department of Cardiovascular Rheumatology,Shanxi Children′s Hospital,Taiyuan030025,China)

机构地区：[1]山西省儿童医院心血管风湿科,太原030025

出　　处：《山西医药杂志》2021年第19期2752-2755,共4页Shanxi Medical Journal

摘　　要：目的通过分析1岁以下婴儿川崎病临床特点及实验室检查,探讨婴儿川崎病冠状动脉损伤的相关因素。方法对2017年1月至2019年12月期间住院的婴儿川崎病98例患儿进行临床资料及实验室数据回顾分析,并将婴儿川崎病组分为:冠状动脉损伤(CAL)组与无冠状动脉损伤(NCAL)组进行比较。结果单因素分析结果显示,与无冠状动脉损伤患儿相比,冠状动脉损伤婴儿无明显性别差异,CAL组的胃肠道症状发生率、C反应蛋白(CRP)、降钙素原(PCT)高于NCAL组。皮疹发生率、白蛋白水平低于NCAL组。静脉注射用免疫球蛋白(IVIG)无反应型川崎病发生率CAL组明显高于NCAL组。多因素Logistic分析显示,CRP、PCT升高是川崎病婴儿并发冠状动脉损伤的独立危险因素,有皮疹症状发生是川崎病婴儿并发冠状动脉损伤的保护因素。结论CRP、PCT升高是川崎病婴儿并发冠状动脉损伤的独立危险因素,有皮疹症状发生是川崎病婴儿并发冠状动脉损伤的保护因素。对于婴儿川崎病患儿,尤其是IVIG无反应型川崎病婴儿,需密切监测心脏超声冠状动脉的改变,警惕较远期冠状动脉病变以及病情进展。Objective To investigate the related factors of coronary artery injury(CAL)in infants with Kawasaki disease(KD)by analyzing the clinical characteristics and laboratory examination on the infants under 1 year old.Methods The clinical data and laboratory data of 98 infants with KD admitted to Shanxi Children's Hospital from January 2017 to December 2019 were retrospectively analyzed.All the infants were divided into CAL group and no coronary artery injury(NCAL)group.Results Univariate analysis showed that compared with patients without CAL,there was no significant gender difference in infants with CAL.The incidence of gastrointestinal symptoms,C-reactive protein(CRP)and procaicltonin(PCT)in the CAL group were higher than those in the NCAL group.The incidence of rash and the level of albumin were lower than those in NCAL group.The incidence of intravenous immunogloblin(IVIG)inactive in the CAL group was significantly higher than that in the NCAL group.Multivariate Logistic analysis showed that elevated CRP and PCT were independent risk factors for complication of CAL in infants with KD,and rash symptoms were protective factors for complication of CAL in infants with KD.Conclusion Elevated CRP and PCT are independent risk factors of CAL in infants with KD,and rash is a protective factor of coronary artery injury in infants with KD.For infants with KD,especially infants with IVIG non-responsive type KD,coronary artery changes should be closely monitored by cardiac ultrasound,and long-term CAL and disease progression should be alert.

关 键 词：黏膜皮肤淋巴结综合征 婴儿 危险因素 冠状动脉损伤 

分 类 号：R725.4[医药卫生—儿科]