川崎病患儿血浆纤维蛋白原、D-二聚体和急性时相蛋白的动态变化及意义

The Dynamic Changes and Significance of Fibrinogen,The D-dimer and Acute Phase Proteins in Children with Kawasaki Disease

目的:观察川崎病(KD)患儿血浆纤维蛋白原(Fib)、D-二聚体和急性时相蛋白(CRP)的动态变化,研究血浆Fib、D-二聚体和CRP改变与冠状动脉病变(CAL)之间的关系。方法:对按要求完成完整复查的43例川崎病患儿进行定期血浆Fib、D-二聚体和CRP水平的检测,选择同期同年龄段笔者所在医院门诊体检的30例健康儿童作为对照组,检测项目及方法同KD组,分析两组儿童血浆Fib、D-二聚体和CRP水平是否存在差别;根据二维彩色超声心动图将43例KD患儿分为有冠状动脉损伤组(CAL组)12例和无冠状动脉损伤组(NCAL组)31例,分析其Fib、D-二聚体和CRP水平是否存在差异。结果:KD组患儿的血浆Fib水平、D-二聚体及CRP均高于健康对照组(P<0.05);CAL组患儿的血浆Fib、D-二聚体及CRP水平均高于NCAL组(P<0.05);Fib、D-二聚体水平与CRP呈正相关(r=1.231,0.876,P<0.05)。结论:Fib及D-二聚体与KD血管损伤的发生、发展有密切的关系,Fib和D-二聚体水平同时升高反映了KD患儿存在明显的高凝状态和血栓形成倾向,对冠状动脉损伤具有较好的预测价值。

Objective：To observe the dynamic changes of fibrinogen, the d-dimer and CRP in children with Kawasaki disease, explore the relation between plasma fibrinogen, the d-dimer, CRP change and coronary artery disease （CAL）.nethods：43 cases completing review between January 2009 and December 2011 were collected, compared with 30 healthy children in the same age in the health clinic of author＇ s hospital in the same period.Two groups had detected and compared fibrinogen, the d-dimer, CRP Level, According to the 2 D color echocardiography, author divided 43 cases of KD into the coronary artery damage group （CAL group） 12 cases and no coronary artery damage group （NCAL group） 31 cases, analyzed their Fib, the d-dimer and CRP level.Results：The level of fibrinogen, the d-dimer, CRP in children with Kawasaki disease was higher than the level of fibrinogen, the d-dimer, CRP in healthy children, the difference had the statistical significance（P〈O.05）.The level of fibrinogen, the d-dimer, CRP in CAL group was higher than in NCAL group, they had the statistical significance（P〈0.05）.The level of d-dimer, Fib and CRP were positively correlated（r=1.231, 0.876, P〈0.05）.Conelusion：They have close relations between Fib, the d-dimer and vascular injury occurrence, development of KD.The Fib and D-dimer level rise reflecting obvious high condensation state and thrombosis tendency in children with Kawasaki disease, The Fib and D-dimer level also have good prediction value for coronary artery damage.