小儿川崎病并发冠状动脉病变高危因素探讨

Investigation on the Risk Factors of Kawasaki Disease with Complication of Coronary Artery Disease in Children

目的:探讨川崎病并发冠状动脉病变的相关因素。方法:对86例确诊为川崎病患儿的临床表现、超声心动图、急性期C—反应蛋白、胆固醇、血沉、血小板、血红蛋白、白细胞等资料进行计量资料t检验和计数资料χ2检验。结果:86例川崎病并发冠状动脉病变26例(30%)。相关因素分析显示:发病年龄、发热天数、血小板、C—反应蛋白、胆固醇与冠状动脉病变发生率有密切关系。用静脉丙种球蛋白(IVIG)治疗的冠状动脉病变发生率23.6%,仅用阿司匹林治疗的冠状动脉病变发生率57.1%,7d内使用IVIG治疗的冠状动脉病变发生率6.4%(P<0.01)。结论:对川崎病进行综合分析,可对该病作出及时的预后判断,予早期干预,促进冠状动脉病变的恢复;早期足量使用IVIG可减少KD并发冠状动脉病变的发生。

Objective： To investigate the relative rish factors for Kawasaki disease with complication of coronary artery disease. Methods： Restrospectively studied 86 children who suffered from the Kawasaki diseas. After investigating the clinical behavior, ultrasonic cardiograms and blood test results of acute prase（Including the Cholesterol ESR, CRP, Platelet, Hemoglobin, Leucocyte）, we analyzed the case by t-test and chisquare test analysis. The incidence rate of coronary artery injury was 33. 3 % in cases who received WIG therapy, while 64. 2% in cases who only received aspirin therapy; but incidence rate of coronary artery injury was 9.6% in cases who received IVIG therapy within 7 days（P〈0. 013. Results： Among 86 cases, the number of patients who got the complication of coronary artery disease was 26（30%）. After analyzing the risk factors we find that fever duration,platelet,CRP,Cholesterol had Close relationship with the disease of coronary artery（P 〈0.01）. Conclusion： With help of medical analysis on the disease and combining the positive physical and laboratory findings,we can timely pre-diagnose the disease and give appropriate treatment in advance to prevent coronary artery disease and help the recovery of pathological changes for coronary artery; full-dose IVIG therapy in early stage can reduce the incidence of coronary artery injure.