川崎病患儿急性期凝血功能的检测与分析

Blood coagulation function in children with Kawasaki disease in acute stag

目的了解川崎病患儿急性期凝血功能状态,并探讨可能的致病机制。方法设病例组48例(住院的川崎病患儿),根据入院时冠状动脉超声检查结果,分为冠状动脉病变组(CAL组)12例,无冠状动脉病变组(NCAL组)36例,同时设健康对照组30例。检测3组凝血功能,即凝血酶原时间(PT)、凝血酶时间(TT)、部分凝血酶原活化时间(APTT)和纤维蛋白原定量(FIB)值,对结果进行统计学分析。结果川崎病患儿CAL组在急性期的PT、APTT、TT均较对照组缩短,而FIB则较对照组增高,差异均有高度显著性(P≤0.01);NCAL组在急性期的PT、APTT较对照组明显缩短(P<0.01),FIB较对照组增高(P=0.01);CAL组与NCAL组比较,PT、APTT、TT明显缩短(P≤0.01),FIB值增高(P=0.02)。结论川崎病患儿急性期凝血功能处于高凝状态,较易合并冠状动脉病变,推测与血管炎症活动有关。

Objective To study the changes and mechanisms of blood coagulation in children with Kawasaki disease （KD） in acute stage. Methods Forty-eight KD children were as case group, according to the examination result of coronary artery ultrosonography , 12 of 48 patients were in coronary artery lesion group（CAL） and 36 patients were in non-coronary artery lesion group（NCAL）, another 30 persons were as health control group. Function of blood coagulation including prothrombin time（PT）, thrombin time（TT）, activated partial thromboplastin time （APTT） and fibrinogen （FIB） were determined and compared among these groups. Results Compared with pa- tients in control group, the PT,TT and APTT was shorter in CAL group, and the FIB was higher than those in control group, the difference was significant （P〈0. 01 ） ; the PT and APTT were both shorter in NCAL group（P〈 0. 01）, and FIB was higher （P = 0. 01） ; compared with NCAL group, the PT, TT and APTT was shorter in CAL group（P〈0. 01）, and the FIB was higher （P = 0. 02）. Conclusion Hypercoagulability exists in KD children in acute stage, and is susceptible to coronary artery disease, which may be related to blood vascular inflammation.