血小板计数、C反应蛋白和D-二聚体在川崎病患儿冠脉病变的临床意义

摘要

目的 探讨血小板计数、C反应蛋白和D-二聚体在川崎病(kawasaki disease,KD)患儿冠脉病变的临床意义.方法 选取2013年1月~2015年12月义乌市中心医院儿科收治的54例KD患儿,根据心脏超声检查结果分为有冠状动脉损伤(CAL)组(n=15)和无冠状动脉损伤(NCAL)组(n=39),检测2组急性期、恢复期血小板计数、C反应蛋白和D-二聚体变化与冠状动脉损害的关系.另检测54名健康儿童(对照组)血小板计数、C反应蛋白和D-二聚体进行对比.结果 急性期KD患儿血小板计数、C反应蛋白、D-二聚体水平明显高于对照组(P<0.05),恢复期KD患儿C反应蛋白和D-二聚体在治疗后显著下降(P<0.05),血小板计数则明显升高(P<0.01),对于有冠脉损伤组KD患儿血小板计数、C反应蛋白和D-二聚体水平与无冠脉损伤组相比,无论在急性期还是在恢复期,差异均具有统计学意义(P<0.05).结论 血小板计数、C反应蛋白和D-二聚体水平变化与KD患儿的心血管损害关系密切.%Objective To explore the clinical significance of platelet count, C-reaction protein and D-dimer in Kawasaki disease children with coronary artery lesion. Methods 54 cases of children with KD treated in our hospital from January 2013 to December 2015 were divided into coronary artery injury (CAL) group (n=15) and without coronary artery injury (NCAL) group (n=39), according to the cardiac ultrasound examination. The relationship between the changes of platelet count, C reactive protein and D- two and coronary artery lesion in the 2 groups of acute and convalescent stages were detected. Platelet count, C-reaction protein and D-dimer of 54 healthy children were measured as a control. Results The levels of the platelet count, C-reaction protein and D-dimer of the KD children during acute stage are significantly higher than the control group (P<0.05), while the levels of C-reaction protein and D-dimer of the KD children during recovery stage was significantly decreased after treatment (P<0.05), the platelet count is remarkably increased (P<0.01). The platelet count, C-reaction protein and D-dimer for the KD children with coronary artery malformation, either at acute stage or recovery stage, compared with the control group were significantly different (P<0.05), with statistical significance. Conclusion The changes of the platelet count, C-reaction protein and D-dimer levels have close relations with the cardiovascular damage to the KD children.