川崎病合并肺炎支原体感染患儿实验室检查指标及临床特征研究

Clinical Characteristics and Inflammation-associated Factors of Peripheral Blood in Kawasaki Disease Children with Mycoplasma Pneumoniae Infection

目的探讨川崎病(KD)合并肺炎支原体(MP)感染患儿实验室检查指标和临床特征的变化。方法回顾性分析2008年1月—2011年12月以发热3～5 d收治我院儿科,最后确诊为KD的107例患儿的临床资料,分为无MP感染组和合并MP感染组。对两组患儿外周血超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞计数(WBC)、血小板计数(PLT)、红细胞沉降率(ESR)、谷氨酸氨基转移酶(ALT)和肌酸激酶心型同工酶(CK-MB)进行对比分析,并统计两组的治疗与转归。结果 107例KD患儿中合并MP感染者36例,占33.64%。合并MP感染组患儿hs-CRP、PCT、ALT、CK-MB水平高于无MP感染组,差异有统计学意义(P<0.05)。无MP感染组与合并MP感染组WBC、PLT、ESR水平比较差异无统计学意义(P>0.05)。无MP感染组冠状动脉异常19例(占26.76%),合并MP感染组21例(占58.33%),两组比较差异有统计学意义(χ2=10.17,P<0.05)。无MP感染组平均住院时间(6.5±2.1)d,合并MP感染组(8.9±3.7)d,两组比较差异有统计学意义(t=3.64,P<0.05)。1～3个月后复查心脏彩超,两组冠状动脉损害恢复情况比较差异无统计学意义(P>0.05)。结论合并MP感染KD患儿hs-CRP、PCT、GPT、CK-MB水平高于无MP感染的KD患儿,且病程长,冠状动脉损害多,合并其他脏器损害多。

Objective To analyse clinical characteristics and laboratory data of children with mycoplasma pnenmoniae （MP） infection of kawasaki disease （KD）. Methods Totally 107 KD children with MP infection who were hospitalized from January 2008 to December 2011 in our hospital were divided into KD without MP group and KD with MP group. The hs - CRP, PCT, ESR, ALT, CK - MB, and blood routine indicators were determined. Results Of all these 107 patients, 36 （33.64%） were accompanied with MP infection. The hs - CRP, PCT, ALT, and CK - MB showed significant differences be- tween KD without MD group and KD with MP group （ allP 〈 0. 05）, whereas WBC, NE, PLT, and ESR showed no such differ- ence （P 〉 0. 05 ）. Also the coronary artery expansion was significantly different between the two groups （26. 76% vs. 58.33 %, P 〈 0. 05）. The average hospitalization duration was （6. 5 ±2. 1 ） days in KD without MP group and （ 8. 9 ± 3.7 ） days in KD with MP group （t = 3. 64, P 〈 0. 05 ）, although the recovery of coronary artery damage showed no such difference （P 〉 0. 05 ）. Conclusion KD Children with MP infection have longer course of disease, severer coronary artery damage, more other organs damages, and higher hs - CRP and PCT than KD children without MP infection.