川崎病合并冠脉损害类型及高危因素分析

Analysis the types and the high risk factors of Kawasaki disease complicated with coronary artery lesions

目的:分析川崎病(KD)合并冠状动脉损害的类型及高危因素。方法:回顾分析2001年至2008年期间170例住院KD患儿的临床资料,分析冠脉损害的类型,对比冠状动脉损害组和无冠脉损害组之间年龄、热程、血生化及治疗时间等8项影响因素。结果:(1)KD患儿男性明显多于女性,比例达2.33∶1;冠脉损害主要出现在1岁以内和6～10岁的学龄儿童;(2)冠脉损害类型主要为冠脉扩张,单纯左冠脉主干受累达56.3%,左右冠脉同时受累达31.3%,单纯右冠脉受累占9.4%,也可累及左冠状动脉前降支及旋支;(3)热程延长,血小板(PLT)及C反应蛋白(CRP)含量升高(P均<0.05)。结论:单纯左冠脉主干的冠脉损害发生率最高,其次为左右冠脉同时受累,对于<1岁和6～10岁的学龄儿童的KD患儿,发热持续8d以上,PLT≥300.0×109/L,白细胞≥10.0×109/L者要警惕冠脉损害的发生。

Objective： To investigate the types of coronary artery lesions and the high risky factors of in children. Methods： The clinical data of 170 Kawasaki disease children during 2001 to 2008 were examined retrospectively, and the types of coronary artery lesions were analyzed. Results： （1） Boys were more likely to develop KD, the male to female ratio being 2.33 ：1, and the age of children younger than 1 year old and 6-10 years old were more likely to develop coronary artery lesions; （2） There were coronary lesions in 32 case （18.5 %）, in which coronary arteriectasis was 56.3% of them had left coronary artery stem lesions, 31.3% of them had both the left and right coronary artery lesions, and 9.4% of them had right coronary artery lesions; （3） The levels of platelet and C reactive protein （CRP） in Kawasaki disease children were obviously higher （P〈0.05 all）. Conclusion： The left coronary artery stem is the most commonly position of lesion for patients with Kawasaki disease. The 〈1 year old and 6-10 years old children, fever time surpass 8 days, platet≥300× 10^9/L, WBC≥ 10.0 ×10^9/L are possible risky factors of coronary artery lesions.