云南地区川崎病并发冠状动脉病变的临床特征及其风险预测指标分析  

Analysis of Clinical Features and Risk Predictors of Kawasaki Disease Complicated with Coronary Artery Disease in Yunnan Area

作　　者：苏忠剑 陈延菲 刘兴祝 肖颖[1] 李斌[1] 张兴 SU Zhongjian;CHEN Yanfei;LIU Xingzhu;XIAO Ying;LI Bin;ZHANG Xing(Department of Cardiovascular Medicine,Kunming Children's Hospital,Kunming,Yunnan Province,650100 China)

机构地区：[1]昆明市儿童医院心血管内科,云南昆明650100

出　　处：《系统医学》2022年第6期19-24,共6页Systems Medicine

基　　金：云南省教育厅科学研究基金项目(2021J0285;2021J0288)。

摘　　要：目的研究分析云南地区川崎病患儿并发冠状动脉病变的临床特征及其风险预测指标。方法选取2015年1月—2021年6月收治的川崎病患儿500例为研究对象,将无冠状动脉病变患儿纳入对照组(300例),发生冠状动脉病变患儿纳入观察组(200例),整理两组患儿临床资料,汇总分析患儿临床特征及风险预测指标。结果两组基线资料比较,各项指标项差异无统计学意义(P>0.05);临床表现比较,对照组发热时间(7.42±1.29)d短于观察组发热时间(11.33±1.08)d,差异有统计学意义(t=35.385,P<0.05),其他指标比较差异无统计学意义(P>0.05);危险因素分析,观察组丙种球蛋白自发病7 d以后用药138例(69.00%)、有丙种球蛋白拮抗96例(48.00%)、川崎病类型为完全型川崎病92例(46.00%)、血红蛋白>100 g/L共143例(71.50%)、红细胞沉降率<75 mm/h共161例(80.50%)、中性粒细胞/淋巴细胞(NLR)≥3共148例(74.00%)、血小板计数/淋巴细胞(PLR)≥117.7共184例(92.00%)、平均血小板体积(MPV)/淋巴细胞(MPVLR)>6.45共180例(90.00%)、白蛋白>35 g/L共158例(79.00%)、口腔黏膜改变共40例(20.00%)、淋巴结肿大共59例(29.50%)、皮疹共69例(34.50%),与对照组比较,差异有统计学意义(χ^(2)=83.124、15.366、71.006、53.910、98.376、260.017、393.573、371.577、121.675、153.210、141.063、81.249,P<0.05)。结论川崎病患儿冠状动脉病变的发生,是由多种因素影响所导致,与患儿丙种球蛋白使用时间、疾病类型等多方面存在显著相关性,因此,该疾病需于发病后及时进行救治,以此降低冠状动脉病变发生率。Objective To study and analyze the clinical features and risk predictors of coronary artery disease in children with Kawasaki disease in Yunnan.Methods 500 children with Kawasaki disease treated from January 2015 to June 2021 were selected as the research objects.Children without coronary artery disease were included control group(300 cases),and children with coronary artery disease were included observation group(200 cases).The clinical data of the children between the groups were sorted out,and the clinical characteristics and risk prediction indicators of the children were summarized and analyzed.Results There was no statistically significant difference in the comparison of baseline data between groups(P>0.05).In comparison of clinical manifestations,the fever time in the control group was(7.42±1.29)d,shorter than the fever time in the observation group(11.33±1.08)d,and the difference was statistically significant(t=35.385,P<0.05),and there was no statistically significant difference in other in dex(P>0.05).Risk factor analysis showed that in the observation group,138 cases(69.00%)of gamma globulin were treated with gamma globulin since 7 d after onset,96 cases(48.00%)had gamma globulin antagonism,92 cases(46.00%)of Kawasaki disease type were complete Kawasaki disease,hemoglobin>100 g/L in 143 cases(71.50%).There were 161 cases(80.50%)of erythrocyte sedimentation rate<75 mm/h,and 148 cases(74.00%)of neutrophil/lymphocyte(NLR)≥3.Platelet count/lymphocyte(PLR)≥117.7 in 184 cases(92.00%),mean platelet volume(MPV)/lymphocyte(MPVLR)>6.45 in 180 cases(90.00%),Albumin>35 g/L in 158 cases(79.00%),oral mucosa changes in 40 cases(20.00%),lymphadenopathy in 59 cases(29.50%),and rash in 69 cases(34.50%),compared with the control group,the difference was statistically significant(χ^(2)=83.124,15.366,71.006,53.910,98.376,260.017,393.573,371.577,121.675,153.210,141.063,81.249,P<0.05).Conclusion The occurrence of coronary artery disease in children with Kawasaki disease is caused by a variety of factors,and there is a

关 键 词：川崎病 冠状动脉病变 临床特征 风险预测 分析 

分 类 号：R4[医药卫生—临床医学]