40例川崎病合并重症感染患儿的病因及预后分析

Analysls on pathogen and prognosis of 40 Kawasaki disease patients complicated with severe infection

目的探讨川崎病合并重症感染的发病原因及治疗效果。方法选择我院儿科2003年1月至2011年2月收治的川崎病患儿，40例重症感染者作为研究组，40例无感染或中轻度感染者作为对照组。对两组患儿进行治疗，对比治疗后、随访中冠状动脉扩张的例数；并对所有患儿的病例资料进行分析，总结川崎病合并重症感染的病因。结果研究组出院时冠状动脉扩张29例，对照组26例，差异无显著性；出院后1、2年冠状动脉扩张例数较对照组明显减少。研究组红细胞压积、白蛋白均低于对照组，血沉及c反应蛋白高于对照组。结论川崎病合并重症感染患儿预后不理想，容易遗留冠状动脉扩张；红细胞压积、白蛋白、血沉、c反应蛋白可作为判断川崎病预后情况的指标。

Objective To explore and discuss the pathogenesis of Kawasaki disease complicated with severe infection and the effects after treatment. Methods Children with Kawasaki disease treated in our hospital from Jan 2003 to Feb 2011 were selected as objects of the study. 40 children with severe infection were selected as research group and 40 children without or with medium or slight infection were chosen as control group. Patients of the two groups were treated at the same time. Numbers of coronary artery ectasia patients after treatment and during the follow-up visit were compared. Besides, the medical records of patients of the two groups were analyzed to summarize the pathogenesis of Kawasaki disease combined with severe infection. Results There was no significant difference of the numbers of CAE patients between the two groups when they left hospital. Follow-up visits of 1 and 2 years showed obviously decreased number of CAE patients in the research group than those in the control group. Hematocrit and albumin of the research group were all lower than those of control group. Erythrocyte sedimentation rate and C-reactiveprotein of the research group were higher than those of control group. Conclusions Kawasaki disease children complicated with severe infection have poor prognosis, easily bequeathing CAE; hematocrit, albumin, ESR, and C-reactiveprotein can be taken as the indexes determining the prognosis of Kawasaki disease.