MP感染对川崎病患儿血小板参数和血清炎症介质及冠脉损伤的影响  

Influence of MP infection on platelet parameters,serum inflammatory mediators and coronary artery lesion of children with Kawasaki disease

作　　者：李寅洁[1] 吴菱[1] 陈圆玲[1] 钟世玲 戴霞华[1] 戴雯锦 LI Yin-jie;WU Ling;CHEN Yuan-ling;ZHONG Shi-ling;DAI Xia-hua;DAI Wen-jin(Ningbo Women and Children's Hospital,Ningbo,Zhejiang 315012,China)

机构地区：[1]宁波市妇女儿童医院儿科,浙江宁波315012

出　　处：《中华医院感染学杂志》2023年第21期3307-3311,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2019RC267)。

摘　　要：目的探讨肺炎支原体(MP)感染对川崎病(KD)患儿血小板参数和血清炎症介质及冠脉损伤(CAL)的影响.方法选取2020年7月-2022年9月在宁波市妇女儿童医院儿科收治的KD患儿80例,根据是否发生MP感染分为感染组26例和未感染组54例,对比两组患儿临床特征、症状积分、血小板参数[血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)和血小板分布宽度(PDW)]、血清炎症介质[C-反应蛋白(CRP)、白细胞介素(IL)-6、IL-10、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)]水平、CAL发生率及小林评分(Kobayashi score).采用Pearson相关性分析血小板参数、血清炎症介质、Kobayashi score评分与症状积分的关系.结果感染组症状积分、PLT、MPV、PDW和PCT水平均高于未感染组(P<0.05).感染组CRP、IL-6、IL-10、TNF-α和IFN-γ水平均高于未感染组(P<0.05).感染组冠状动脉扩张发生率高于未感染组(38.46%vs.16.67%),Kobayashi score评分高于未感染组(P<0.05).Pearson相关性显示,血小板参数(PLT、MPV、PDW、PCT)、血清炎症介质(CRP、IL-6、IL-10,TNF-α和IFN-γ)和Kobayashi score评分均与症状积分呈正相关(均P<0.05).结论MP感染会加重KD患儿炎症反应,增加血小板参数水平和CAL发生风险,临床应及早检测各指标以提高MP检出率,指导诊疗.OBJECTIVE To explore the influence of Mycoplasma pneumoniae(MP)infection on platelet parameters,serum inflammatory mediators and coronary artery lesion(CAL)of the children with Kawasaki disease(KD).METHODS A total of 8O children with KD who were treated in Ningbo Women and Children's Hospital from Jul 2020 to Sep 2022 were enrolled in the study and were divided into the infection group with 26 cases and the no infection group with 54 cases according to the status of MP infection.The clinical characteristics,scores of symptoms,platelet parameters[platelet counts(PLT),mean platelet volume(MPV),thrombocytocrit(PCT)and platelet distribution width(PDW)],serum inflammatory mediators[C-reactive protein(CRP),interleukin(IL)-6,IL-10,tumor necrosis factor-α(TNF-α),interferon-(IFN-)],incidence of CAL and Kobayashi score were observed and compared between the two groups of children.Pearson correlation analysis was performed for the association between the platelet parameters,serum inflammatory mediators,Kobayashi score and the scores of symptoms.RESULTS The scores of symptoms,PLT,MPV,PDW and PCT levels of the infection group were higher than those of the no infection group(P<0.05).The levels of CRP,IL-6,IL-10,TNF-αand IFN-of the infection group were higher than those of the no infection group(P<0.05).The incidence of coronary artery ectasia of the infection group was 38.46%,higher than 16.67%of the no infection group,and the Kobayashi score of the infection group was higher than that of the no infection group(P<0.05).Pearson correlation analysis showed that the score of symptom was positively correlated with the platelet parameters(PLT,MPV,PDW,PCT),serum inflammatory mediators(CRP,IL-6,IL-10,TNF-αand IFN-)and Kobayashi score(all P<0.05).CONCLUSION The MP infection may aggravate the inflammatory response of the children with KD and lead to the rise of platelet parameters and the risk of CAL.It is necessary for the hospital to detect the indexes as early as possible so as to raise the isolation rate of MP and provide guida

关 键 词：肺炎支原体感染 川崎病 血小板参数 血清炎症介质 冠脉损伤 儿童 

分 类 号：R725.4[医药卫生—儿科]