川崎病与全身型幼年特发性关节炎患儿的临床实验室指标对比分析  

Comparative analysis of clinical laboratory indicators between Kawasaki disease and systemic juvenile idiopathic arthritis

作　　者：张玉娟 陈冠宏[2] 刘婉璐 张寒 Zhang Yujuan;Chen Guanhong;Liu Wanlu;Zhang Han(Department of Pediatrics,Huainan Maternal and Child Health Hospital,Huainan 232000,Anhui Province,China;Department of Joint Surgery,Shanxian Central Hospital,Heze 274300,Shandong Province,China;Department of Pediatrics,Shanxian Central Hospital,Heze 274300,Shandong Province,China)

机构地区：[1]淮南市妇幼保健院儿科,淮南232000 [2]单县中心医院关节外科,菏泽274300 [3]单县中心医院儿科,菏泽274300

出　　处：《中国基层医药》2022年第9期1349-1354,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的对比分析川崎病(Kawasaki disease,KD)与全身型幼年特发性关节炎(systemic juvenile idiopathic arthritis,SJIA)的临床实验室检查指标的差异,为二者诊断和鉴别诊断提供客观依据。方法回顾性分析2017年9月至2022年1月在淮南市妇幼保健院儿科确诊为KD患儿41例(KD组)及SJIA33例患儿(SJIA组),另选择同期该院50例健康儿童作为对照组。分别记录并分析比较两组患儿治疗前及对照组儿童血清降钙素原(PCT)、血小板计数(PLT)、白细胞计数(WBC)、C反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞介素6(IL-6)、白细胞介素10(IL-10)、血清铁蛋白(SF)水平。结果通过单因素方差分析和两两比较的q检验统计学方法比较KD组、SJIA组、对照组三组实验室指标,KD组患儿CRP、ESR、SF、IL-6实验指标均明显低于SJIA组[(57.80±25.23)mg/L比(77.72±45.64)mg/L,(67.02±28.80)mm/h比(83.84±47.64)mm/h,(320.21±182.53)µg/L比(945.58±604.65)µg/L,(50.35±20.54)ng/L比(89.35±45.54)ng/L,q=4.34、3.42、11.51、8.85,均P<0.05],而KD组IL-10水平高于SJIA组[(18.52±16.71)ng/L比(10.01±3.24)ng/L,q=-5.25,P<0.05];另外KD组和SJIA组患儿血清WBC、CRP、ESR、PCT、PLT、IL-6、IL-10、SF等实验室指标均明显高于对照组组(均P<0.05)。结论通过分析对比血液中检测CRP、ESR、SF、IL-6、IL-10等实验室指标,可以为KD和SJIA的早期诊断及鉴别诊断提供客观参考,从而减少临床诊断的误判。Objective To explore the differences of clinical laboratory indicators between Kawasaki disease(KD)and systemic juvenile idiopathic arthritis(SJIA),providing objective evidence for diagnosis and differential diagnosis of these diseases.Methods A total of 41 children patients with KD(KD group)and 33 children patients with SJIA(SJIA group)who received treatment in Huainan Maternal and Child Health Hospital between September 2017 and January 2022 were retrospectively analyzed.An additional 50 healthy children who concurrently received physical examination in the same hospital were included in the control group.Platelet count(PLT),white blood cell count(WBC),and erythrocyte sedimentation rate(ESR)as well as C-reactive protein(CRP),serum procalcitonin(PCT),interleukin-6(IL-6),interleukin-10(IL-10),and serum ferritin(SF)levels were compared among groups before treatment.Results One-way analysis of variance and pairwise q test were performed to compare laboratory indicators among KD,SJIA and control groups.CRP,ESR,SF and IL-6 levels in the KD group were significantly lower than those in the SJIA group[CRP:(57.80±25.23)mg/L vs.(77.72±45.64)mg/L;ESR:(67.02±28.80)mm/h vs.(83.84±47.64)mm/h;SF:(320.21±182.53)µg/L vs.(945.58±604.65)µg/L;IL-6:(50.35±20.54)ng/L vs.(89.35±45.54)ng/L,q=4.34,3.42,11.51,8.85,all P<0.05].IL-10 level in the KD group was significantly higher than that in the SJIA group[(18.52±16.71)ng/L vs.(10.01±3.24)ng/L,q=-5.25,P<0.05].WBC,CRP,ESR,PCT,PLT,IL-6,IL-10 and SF in the KD and SJIA groups were significantly higher than those in the control group(all P<0.05).Conclusion Detection of CRP,ESR,SF,IL-6,IL-10 in blood can provide objective evidence for the early diagnosis and differential diagnosis of KD and SJIA,thereby reducing the misjudgment of clinical diagnosis.

关 键 词：黏膜皮肤淋巴结综合征 关节炎 青少年 诊断 鉴别 C反应蛋白质 转铁蛋白 血沉 白细胞介素6 白细胞介素10 

分 类 号：R725.4[医药卫生—儿科] R725.9[医药卫生—临床医学]