兰州地区川崎病患儿并发冠状动脉损害的危险因素研究

摘要

目的：探讨兰州地区川崎病(KD)患儿并发冠状动脉损害(CAL)的危险因素。方法对确诊的174例KD患儿，根据其是否并发CAL分为CAL组和NCAL组，分析比较其年龄、性别、热程、静脉用丙种球蛋白(IVIG)开始使用时间、IVIG使用剂量、C反应蛋白(CRP)、血清白蛋白、红细胞沉降率(ESR)、血小板(PLT)、血红蛋白等资料的差异。结果174例KD患儿并发CAL者46例(占26.44%)，无并发CAL者128例；两组患儿平均热程、自发热到开始IVIG治疗的时间、IVIG使用剂量，以及PLT、CRP、ESR、红细胞计数(RBC)的差异均有统计学意义(P<0.05)。结论热程>10 d、发热10 d后开始使用IVIG，PLT、CRP、ESR升高，RBC降低的KD患儿应警惕并发CAL的危险性，对于KD的治疗及预后判断有一定的参考价值。%Objective To investigate the risk factors for coronary artery lesions (CALs) in children with Kawasaki disease (KD) in Lanzhou. Methods One hundred and seventy-four children with diagnosed KD were divided into CAL group and non-CAL group based on the existence of concurrent CALs. The age, gender, fever duration, intravenous immunoglobulin (IVIG) start time, IVIG dose, C-reactive protein (CRP), serum albumin, erythrocyte sedimentation rate (ESR), platelet (PLT), red blood cell count (RBC), hemoglobin and so on were compared. Results Among the 174 children, 46 children (26.44%) were complicated by CALs and 128 children were not. The differences of average fever duration, IVIG starting time, IVIG dose, PLT, CRP, ESR and RBC were statistically signiifcant (P<0.05). Conclusions When KD children has the fever durations>10 d, start of IVIG af-ter 10 days of fever, increase of PLT, CRP and ESR and decrease of RBC, clinicians should be alert to the risk of concurrent CAL.