6月龄以下川崎病患儿发生冠状动脉病变的特点及危险因素分析  

Analysis of the characteristics and risk factors of coronary artery lesions in children with Kawasaki disease under 6 months of age

作　　者：李雪琴 王江涛[1] 王晓玲[1] 赵爱玲 谷惠茹[1] 张华丽[1] 刘榕 刘君丽 LI Xueqin;WANG Jiangtao;WANG Xiaoling;ZHAO Ailing;GU Huiru;ZHANG Huali;LIU Rong;LIU Junli(Infant Ward,Children′s Hospital Affiliated to Zhengzhou University/Henan Children′s Hospital/Zhengzhou Children′s Hospital,Zhengzhou,Henan 450018,China)

机构地区：[1]郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院小婴儿病区,河南郑州450018

出　　处：《检验医学与临床》2022年第16期2177-2180,共4页Laboratory Medicine and Clinic

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190905)。

摘　　要：目的分析6月龄以下川崎病(KD)患儿发生冠状动脉病变(CAL)的特点及危险因素。方法选择2017年12月至2021年6月在该院小婴儿病区住院的112例6月龄以下病历资料完整的KD患儿为研究对象。收集患儿的临床资料,包括性别、入院时日龄、KD分型、静注人免疫球蛋白(IVIG)治疗前热程,IVIG治疗前1 d血常规、肝功能、C反应蛋白等实验室指标。分析6月龄以下KD患儿发生CAL的临床特点,并采用多因素Logistic回归分析KD患儿发生CAL的危险因素。结果112例KD患儿CAL的发生率为48.2%;热程≤10 d的患儿共88例,发生CAL者38例,发生率为43.2%,占所有发生CAL患儿的70.4%;热程>10 d的患儿共24例,发生CAL者16例,发生率为66.7%,占所有发生CAL患儿的29.6%。多因素Logistic回归分析结果显示,IVIG治疗前热程长是6月龄以下KD患儿发生CAL的独立危险因素(OR=1.113,P=0.033,95%CI:1.009~1.228,β=0.107)。结论临床医师应对KD进行早期诊断,并早期应用IVIG进行治疗,减少CAL的发生,从而改善KD患儿的预后。Objective To analyze the characteristics and risk factors of coronary artery lesions(CAL)in children with Kawasaki disease(KD)under 6 months of age.Methods A total of 112 KD children with complete medical records under 6 months of age who were hospitalized in the infant ward of the hospital from December 2017 to June 2021 were selected as the research subjects.The clinical data of the children were collected,including gender,age at admission,KD type,fever course before intravenous human immunoglobulin(IVIG)treatment,routine blood,liver function,C-reactive protein and other laboratory indexes at 1 d before IVIG treatment.The clinical characteristics of CAL in children with KD under 6 months of age were analyzed,and multivariate Logistic regression was used to analyze the risk factors of CAL in children with KD.Results The incidence of CAL in 112 KD children was 48.2%.There were 88 children with fever duration≤10 d,and 38 patients had CAL,the incidence rate was 43.2%,accounting for 70.4%of all children with CAL.There were 24 children with fever duration>10 d,and 16 patients had CAL,the incidence rate was 66.7%,accounting for 29.6%of all children with CAL.The results of multivariate Logistic regression analysis showed that long fever duration before IVIG treatment was an independent risk factor for CAL in children with KD under 6 months of age(OR=1.113,P=0.033,95%CI:1.009-1.228,β=0.107).Conclusion Clinicians should make early diagnosis of KD,and use IVIG for early treatment and reduce the occurrence of CAL,thereby improving the prognosis of children with KD.

关 键 词：婴儿 川崎病 冠状动脉病变 热程 静注人免疫球蛋白 

分 类 号：R725.4[医药卫生—儿科]