川崎病并发严重心血管后遗症的高危因素分析  

Analysis of high-risk factors of severe cardiovascular sequelae in Kawasaki disease

作　　者：穆志龙 高颖[1,2] 焦富勇 卫丽[1,2] MU Zhilong;GAO Ying;JIAO Fuyong;WEI Li(Department of Pediatrics,Shaanxi Provincial People′s Hospital,Xi′an,Shaanxi,710068;Department of Pediatrics,Shaanxi Kawasaki Disease Diagnosis and Treatment Center,Xi′an,Shaanxi,710068)

机构地区：[1]陕西省人民医院儿科,陕西西安710068 [2]陕西省川崎病诊疗中心儿科,陕西西安710068

出　　处：《实用临床医药杂志》2023年第11期75-79,共5页Journal of Clinical Medicine in Practice

摘　　要：目的分析儿童川崎病(KD)并发严重心血管后遗症(SCS)的高危因素。方法选取KD患者505例,根据是否存在冠状动脉病变(CAL)分为非严重心血管后遗症(N-GS)组474例和SCS组31例。分析年龄、性别、外周血中白细胞计数(WBC)、发热时间、血红蛋白(Hb)、C反应蛋白(CRP)、红细胞沉降率(ESR)、降钙素原(PCT)、血浆D-二聚体定量(D-D)、抗链球溶血素O定量测定(ASO)、EB病毒(EBV)、静脉注射免疫球蛋白(IVIG)无反应和KD再发与KD并发SCS的相关性。分析KD并发SCS的高危风险因素。结果单因素分析结果显示,ESR、PCT、发热时间>10 d、KD再发、IVIG无反应与KD并发SCS有关(P<0.05)。Logistic回归分析结果显示,发热时间>10 d(OR=6.73,95%CI:1.75-22.94,P=0.02)、KD再发(OR=3.87,95%CI:1.43-8.55,P=0.04)、IVIG无反应(OR=4.28,95%CI:1.62-9.75,P=0.03)为KD并发SCS的独立高危因素。结论发热时间>10 d、KD再发及IVIG无反应是KD并发SCS的高危因素。Objective To analyze the high-risk factors of severe cardiovascular sequelae(SCS)in children with Kawasaki disease(KD).Methods A total of 505 KD patients were selected and divided into non-severe cardiovascular sequelae(N-GS)group(474 cases)and SCS group(31 cases)according to the presence of coronary artery disease(CAL).Age,gender,peripheral blood white blood cell count(WBC),fever duration,hemoglobin(Hb),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),plasma D-dimer assay(DD),antistreptomolysin O assay(ASO),Epstein-Barr virus(EBV),intravenous immunoglobulin(IVIG)nonresponse and recurrence of KD were correlated with KD complicated with SCS.The high-risk factors of KD concurrent SCS were analyzed.Results Single factor analysis showed that ESR,PCT,fever time>10 days,KD recurrence and IVIG nonresponse were related to KD complicated with SCS(P<0.05).Logistic regression analysis showed that fever time>10 days(OR=6.73;95%CI,1.75 to 22.94;P=0.02),KD recurrence(OR=3.87;95%CI,1.43 to 8.55;P=0.04)and IVIG nonresponse(OR=4.28;95%CI,1.62 to 9.75;P=0.03)were independent high-risk factors for KD complicated with SCS.Conclusion Fever time>10 days,KD recurrence and IVIG nonresponse are high-risk factors for KD complicated with SCS.

关 键 词：川崎病 儿童 严重心血管后遗症 危险因素 静脉注射免疫球蛋白 

分 类 号：R541[医药卫生—心血管疾病] R72[医药卫生—内科学]