呼吸道病毒感染对川崎病发病影响的研究

Effects of Respiratory Viral Infections on Kawasaki Disease

目的探讨呼吸道病毒感染在川崎病发病中的作用。方法我院儿科2005年6月—2010年6月收治川崎病患儿125例,其中呼吸道病毒检测阳性13例为实验组,每个实验组患儿由2个同年龄、同性别的对照组(呼吸道病毒检测阴性)成员与其相配。对比分析两组患儿的临床表现、实验室检查结果、彩色超声心动图结果及住院时间。结果 125例患儿中有106例进行呼吸道病毒抗原检测,阳性者13例,阳性率达12.26%,包括腺病毒4例,副流感病毒1、2、3型4例,流感病毒A、B型3例,呼吸道合胞病毒2例。实验组患儿呕吐发生率较对照组明显升高,差异有统计学意义(P<0.05)。实验组表现为不完全川崎病5例(占38.5%),对照组表现为不完全川崎病3例(占11.5%),两组比较差异有统计学意义(P<0.05)。实验组患儿C反应蛋白、红细胞沉降率较对照组均明显降低,差异有统计学意义(P<0.05)。实验组冠状动脉扩张发生率较对照组明显升高,差异有统计学意义(P<0.05)。两组住院时间比较差异无统计学意义(P>0.05)。结论伴有呼吸道病毒感染的川崎病患儿临床表现以不完全川崎病为多见,且更易发生心血管病变。早期诊断与合理治疗能改善患儿的生活质量,预防心血管疾病的发生。

Objective To investigate the role of respiratory viruses in the pathogenesis of kawasaki disease（KD）.Methods The clinical data of 125 hospitalized KD children were analyze retrospectively.Patients with positive respirovirus test results were divided into test group,each of the children in test group matched 2 members（of the same age and gender）of control group（with negative results）.The clinical manifestations,laboratory and echocardiography findings and hospital stay were compared between 2 groups.Results During the study period,125 patients were hospitalized in our hospital with KD.Viral testing was performed in 106 patients.13 patients had a respiratory virus identified,including adenovirus（n=4）,RSV（n=2）,influenza A or B（n=3）,PIV 1,2,3（n=4）.The clinical criteria,except for emesis,which was documented more frequently in KD patients with viral infections;the rest of factors evaluated were similar between groups.Children with viral infections were diagnosed more often with incomplete KD than were those with negative viral results（cases 38% vs.controls 11%;P〈0.05）.Laboratory results,acute-phase reactants（ESR and CRP）showed a trend toward lower values in children with KD and concomitant viral infections,the rest of factors evaluated were similar between groups.Echocardiographic examinations,coronary artery dilatations showed a higher frequency in KD patients with viral infections;the rest of factors evaluated were similar between groups.In 125 children,106 underwent respirovirus antigen detection,13 were positive（12.26%）,including 4 adenovirus,4 parainfluenza virus I,II,III,3 influenza virus A,B,2 RS virus.Conclusion Patients with concomitant viral infections had a higher frequency of coronary artery dilatations and were significantly more often diagnosed with incomplete KD.